Provider Demographics
NPI:1831623610
Name:TORN, ALYSSA R (PT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:R
Last Name:TORN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:R
Other - Last Name:JACKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:N91W15750 FALLS PKWY
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2301
Mailing Address - Country:US
Mailing Address - Phone:262-532-1100
Mailing Address - Fax:
Practice Address - Street 1:N91W15750 FALLS PKWY
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2301
Practice Address - Country:US
Practice Address - Phone:262-532-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11828-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist