Individual
ALYSSA MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1221 MERCANTILE LANE, UPPER MARLBORO, MD 20774
(301) 386-6600
(724) 770-7947
Mailing address
1221 MERCANTILE LANE, UPPER MARLBORO, MD 20774
(724) 773-8900
(724) 770-7947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
D0034658
DC
207Q00000X
Family Medicine Physician
Primary
H83105
MD
207Q00000X
Family Medicine Physician
OT015909
PA
Other
Enumeration date
06/04/2014
Last updated
06/06/2021
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