Individual
ALYSSA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2475 BOARDWALK, NORMAN, OK 73069-6332
(405) 447-1991
Mailing address
3317 GREEN WING CT, OKLAHOMA CITY, OK 73120-5013
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5117
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200643840A
—
OK
01
—
5117
STATE LICENSE
OK
Enumeration date
05/23/2016
Last updated
01/11/2017
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