Provider Demographics
NPI:1144602079
Name:GREENE, ALISHA LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:LYNN
Last Name:GREENE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:LYNN
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 LINCOLN GARDENS RD
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-8428
Mailing Address - Country:US
Mailing Address - Phone:717-926-5245
Mailing Address - Fax:
Practice Address - Street 1:1351 WALNUT RD
Practice Address - Street 2:
Practice Address - City:HONEY BROOK
Practice Address - State:PA
Practice Address - Zip Code:19344-1233
Practice Address - Country:US
Practice Address - Phone:610-273-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-27
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024418225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist