Provider Demographics
NPI:1730517046
Name:MCCARTHY, ALYSSA P (DPT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:P
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:P
Other - Last Name:MOYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1468 BRIARWOOD RD NE
Mailing Address - Street 2:#1508
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-5730
Mailing Address - Country:US
Mailing Address - Phone:405-816-3651
Mailing Address - Fax:770-485-7173
Practice Address - Street 1:2221 PEACHTREE RD NE
Practice Address - Street 2:SUITE D336
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1148
Practice Address - Country:US
Practice Address - Phone:404-846-0899
Practice Address - Fax:404-846-0886
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist