Individual
ALYSE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1000 14TH ST, MERIDIAN, MS 39301-4457
(601) 917-9680
(601) 917-9651
Mailing address
1000 14TH ST, MERIDIAN, MS 39301-4457
(601) 917-9680
(601) 917-9651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6471
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03257702
—
MS
Enumeration date
08/31/2014
Last updated
03/18/2025
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