Provider Demographics
NPI:1760169205
Name:GAMMONS, ALAYNA KELSI (DPT)
Entity Type:Individual
Prefix:
First Name:ALAYNA
Middle Name:KELSI
Last Name:GAMMONS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 AUDREY MANOR CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4919
Mailing Address - Country:US
Mailing Address - Phone:301-861-8573
Mailing Address - Fax:
Practice Address - Street 1:4225 ALTAMONT PL STE 102
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3039
Practice Address - Country:US
Practice Address - Phone:301-932-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program