Provider Demographics
NPI:1932984044
Name:HUGGINS, ALYSSA JNAI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JNAI
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:OK
Mailing Address - Zip Code:73542-6201
Mailing Address - Country:US
Mailing Address - Phone:580-335-4918
Mailing Address - Fax:
Practice Address - Street 1:113 S 20TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:OK
Practice Address - Zip Code:73542-6201
Practice Address - Country:US
Practice Address - Phone:580-335-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCP024758T225100000X
OK6376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist