Provider Demographics
NPI:1295137032
Name:CARTER, ALYSSA LAUREN (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:LAUREN
Last Name:CARTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:LAUREN
Other - Last Name:GREENAWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, OCS
Mailing Address - Street 1:17419 BRIDGE HILL CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3599
Mailing Address - Country:US
Mailing Address - Phone:813-907-7879
Mailing Address - Fax:
Practice Address - Street 1:17419 BRIDGE HILL CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3599
Practice Address - Country:US
Practice Address - Phone:813-907-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011552225100000X
FLPT33462225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist