Provider Demographics
NPI:1942753538
Name:POND, ALYSSIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALYSSIA
Middle Name:
Last Name:POND
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 1:152 W LAUREL ST APT 406
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2372
Mailing Address - Country:US
Mailing Address - Phone:717-875-8029
Mailing Address - Fax:
Practice Address - Street 1:152 W LAUREL ST APT 406
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-2372
Practice Address - Country:US
Practice Address - Phone:717-875-8029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist