Individual
ALYCE MAY EWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
2530 PROFESSIONAL PKWY, SANTA MARIA, CA 93455-8200
(805) 928-4465
(805) 928-7935
Mailing address
PO BOX 6450, SANTA MARIA, CA 93456-6450
(805) 928-4465
(805) 928-7935
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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