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NPI Code Detail

MEDICARE: SAMUEL WALTER ALLISON

MEDICARE: SAMUEL WALTER ALLISON
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
1225100000XPhysical Therapist29469MD

General Provider Information

NPI Number : 1457046591
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL WALTER ALLISON
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7629 BELAIR RD
Second Line :
City : NOTTINGHAM
State : MD
Zip : 21236-4003
Country : US
Telephone Number : 410-870-2104
Fax Number : 410-870-6896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2023
Last Update Date : 11/19/2024

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Directions to “ SAMUEL WALTER ALLISON ” Practice Location

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