Individual
ALYSSA L. DETOMMASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2516 E DUPONT RD, FORT WAYNE, IN 46825-1608
(260) 458-3050
(260) 479-4621
Mailing address
2516 E DUPONT RD, FORT WAYNE, IN 46825-1608
(260) 458-3050
(260) 479-4621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002198A
IN
Other
Enumeration date
11/23/2016
Last updated
10/13/2025
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