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General NPI Number Information
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NPI Number | 1790387470
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Entity Type | Individual
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Provider Name | ALYSSA THARP DPT
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Gender | Female
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 205 INDUSTRIAL CV
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City | RIDGELAND
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State | MS
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Zip | 39157-2715
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Country | US
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Telephone | 877-407-3422
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Fax | 877-407-4329
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Provider Business Mailing Address
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Address Line | 103 NOVARA CV
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City | MADISON
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State | MS
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Zip | 39110-6850
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Country | US
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Telephone | 601-503-7247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6959
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License Number State | MS
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