Healthcare Provider Details

I. General information

NPI: 1134761521
Provider Name (Legal Business Name): ALYSSA LIVORIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 GARDEN CENTER DR
GREENSBURG PA
15601-1351
US

IV. Provider business mailing address

655 S WILLOW ST STE 128
MANCHESTER NH
03103-5717
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number293329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: