Provider Demographics
NPI:1447139100
Name:ROTZ, ALYSSA KATHERINE IRENE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KATHERINE IRENE
Last Name:ROTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17246-0044
Mailing Address - Country:US
Mailing Address - Phone:717-494-3184
Mailing Address - Fax:
Practice Address - Street 1:144 S 8TH ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2755
Practice Address - Country:US
Practice Address - Phone:717-748-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATPTA0008712081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine