Provider Demographics
NPI:1760645774
Name:DEAL, ALYSHA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:DEAL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 WALTHOUR RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-3224
Mailing Address - Country:US
Mailing Address - Phone:912-659-6290
Mailing Address - Fax:
Practice Address - Street 1:1617 WALTHOUR RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-3224
Practice Address - Country:US
Practice Address - Phone:912-659-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist