Provider Demographics
NPI:1467053595
Name:KLINEDINST, ALYSSA MARIE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:MARIE
Last Name:KLINEDINST
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1324
Mailing Address - Country:US
Mailing Address - Phone:717-819-8890
Mailing Address - Fax:
Practice Address - Street 1:550 N 12TH ST
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1242
Practice Address - Country:US
Practice Address - Phone:717-737-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE012596225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant