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Individual

ALYSSA HERZOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1195 HAZEL LN, FARMINGTON, MO 63640-1920
(573) 756-2937
(636) 756-2939
Mailing address
647 SPIRIT AIRPARK WEST DR STE 101, CHESTERFIELD, MO 63005-1032
(636) 206-4225

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2023021570
MO

Other

Enumeration date
06/12/2023
Last updated
10/30/2025
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