Provider Demographics
NPI:1730876301
Name:ALPHA MAMA PHYSICAL THERAPY & WELLNESS, LCC
Entity type:Organization
Organization Name:ALPHA MAMA PHYSICAL THERAPY & WELLNESS, LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:830-734-1577
Mailing Address - Street 1:21510 LONGWOOD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2100
Mailing Address - Country:US
Mailing Address - Phone:830-734-1577
Mailing Address - Fax:
Practice Address - Street 1:21510 LONGWOOD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2100
Practice Address - Country:US
Practice Address - Phone:830-734-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy