Healthcare Provider Details

I. General information

NPI: 1760645774
Provider Name (Legal Business Name): ALYSHA DEAL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5108 NORTHWIND BLVD
VALDOSTA GA
31605-7672
US

IV. Provider business mailing address

5108 NORTHWIND BLVD
VALDOSTA GA
31605-7672
US

V. Phone/Fax

Practice location:
  • Phone: 229-244-1201
  • Fax:
Mailing address:
  • Phone: 229-244-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT009328
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: