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Individual

ALYSA MORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3833 COON RAPIDS BLVD, SUITE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338
Mailing address
3833 COON RAPIDS BLVD, SUITE 100, COON RAPIDS, MN 55433-2697
(763) 427-8320
(763) 302-4338

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10819
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1092837
NCCPA
Enumeration date
06/10/2010
Last updated
08/09/2019
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