Provider Demographics
NPI:1407644230
Name:CLEMENS, ALYSHA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:CLEMENS
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2581 NATURE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46582-6557
Mailing Address - Country:US
Mailing Address - Phone:574-527-3391
Mailing Address - Fax:
Practice Address - Street 1:2581 NATURE VIEW DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46582-6557
Practice Address - Country:US
Practice Address - Phone:574-527-3391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012447A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist