Provider Demographics
NPI:1669623229
Name:FROMKIN, ALISSA PAM (CMT)
Entity type:Individual
Prefix:MISS
First Name:ALISSA
Middle Name:PAM
Last Name:FROMKIN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KING ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4880
Mailing Address - Country:US
Mailing Address - Phone:802-658-8410
Mailing Address - Fax:802-865-4606
Practice Address - Street 1:35 KING ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4880
Practice Address - Country:US
Practice Address - Phone:802-658-8410
Practice Address - Fax:802-865-4606
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT327062-00225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist