Individual
ALYSSA GRACE BOURGET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
128 SNOW HILL ST, AYDEN, NC 28513-7237
(252) 746-8223
Mailing address
123 FALLIN BLVD APT C5, GOLDSBORO, NC 27534-4364
(513) 850-3811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19370
NC
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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