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Individual
ALYCE MAY EWEN
Active
Individual
ALYCE MAY EWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT25900
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT259000
BLUE SHIELD
CA
05
—
PT025900
—
CA
Enumeration date
01/02/2007
Last updated
03/31/2021
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