Provider Demographics
NPI:1083049084
Name:ERSPAMER, ALYSSA J (PTA, NSCA-CPT)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:J
Last Name:ERSPAMER
Suffix:
Gender:F
Credentials:PTA, NSCA-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3537
Mailing Address - Country:US
Mailing Address - Phone:906-236-2689
Mailing Address - Fax:
Practice Address - Street 1:435 STONEVILLE RD
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-2921
Practice Address - Country:US
Practice Address - Phone:906-485-1073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004026225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant