MEDICARE: ALYSSA KATHERINE IRENE ROTZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	TPTA000871	PA

General Provider Information

NPI Number	:	1447139100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA KATHERINE IRENE ROTZ

Provider Business Mailing Address
First Line	:	PO BOX 44
Second Line	:
City	:	PLEASANT HALL
State	:	PA
Zip	:	17246-0044
Country	:	US
Telephone Number	:	717-494-3184
Fax Number	:

Provider Business Practice Location Address
First Line	:	144 S 8TH ST
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-2755
Country	:	US
Telephone Number	:	717-748-9100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2025
Last Update Date	:	08/28/2025

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