Provider Demographics
NPI:1265776199
Name:MILLSAP, ALYSSA MCCLURE (PT DPT)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:MCCLURE
Last Name:MILLSAP
Suffix:
Gender:
Credentials:PT DPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 32486
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40232-2486
Mailing Address - Country:US
Mailing Address - Phone:502-587-1236
Mailing Address - Fax:502-587-0126
Practice Address - Street 1:13151 MAGISTERIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4103
Practice Address - Country:US
Practice Address - Phone:502-587-1236
Practice Address - Fax:502-587-0126
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXCP031100T225100000X
NCCP025837T225100000X
TNCP024435T225100000X
KY008245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist