Provider Demographics
NPI:1942802210
Name:HAMMOCK, ALYSSA (MA, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:HAMMOCK
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 FALLS RD APT 207
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-4432
Mailing Address - Country:US
Mailing Address - Phone:919-605-1946
Mailing Address - Fax:
Practice Address - Street 1:3400 N WESLEYAN BLVD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8699
Practice Address - Country:US
Practice Address - Phone:919-605-1946
Practice Address - Fax:252-985-5589
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20000278322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer