Provider Demographics
NPI:1245943679
Name:ODDIS, ALLYSON MARGARET (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:MARGARET
Last Name:ODDIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 WESTERN WAY
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3225
Mailing Address - Country:US
Mailing Address - Phone:724-762-7918
Mailing Address - Fax:
Practice Address - Street 1:2455 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-4619
Practice Address - Country:US
Practice Address - Phone:724-334-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist