Provider Demographics
NPI:1679319784
Name:PAGANO, ALYSSA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:MARIE
Last Name:PAGANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:CARROLLTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15722-0646
Mailing Address - Country:US
Mailing Address - Phone:814-344-8740
Mailing Address - Fax:814-344-8748
Practice Address - Street 1:204 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CARROLLTOWN
Practice Address - State:PA
Practice Address - Zip Code:15722-7210
Practice Address - Country:US
Practice Address - Phone:814-344-8740
Practice Address - Fax:814-344-8748
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor