MEDICARE: CHELSEA 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
1	225200000X	Physical Therapy Assistant	27015	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27015	OTHER	FL	PTA LICENSE

General Provider Information

NPI Number	:	1922559079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA ALLISON

Provider Business Mailing Address
First Line	:	6751 SPINNER DR.
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33898
Country	:	US
Telephone Number	:	863-521-1619
Fax Number	:

Provider Business Practice Location Address
First Line	:	6751 SPINNER DR
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33898-9277
Country	:	US
Telephone Number	:	863-521-1619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	10/24/2016

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Directions to “ CHELSEA ALLISON ” Practice Location

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