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NPI Code Detail

MEDICARE: ALLISON KING

MEDICARE: ALLISON KING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253J00000XFoster Care AgencyAS280378535MI

General Provider Information

NPI Number : 1093549446
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON KING
Provider Business Mailing Address
First Line : 3935 E LONG LAKE RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-8876
Country : US
Telephone Number : 231-883-6304
Fax Number :
Provider Business Practice Location Address
First Line : 3935 E LONG LAKE RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-8876
Country : US
Telephone Number : 231-883-6304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2024
Last Update Date : 08/28/2024

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Directions to “ ALLISON KING ” Practice Location

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