Healthcare Provider Details

I. General information

NPI: 1720902430
Provider Name (Legal Business Name): MORGAN ALLYNN ILSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2972 CARTER HILL RD
MONTGOMERY AL
36106-2531
US

IV. Provider business mailing address

101 BELSER BLVD
PIKE ROAD AL
36064-2725
US

V. Phone/Fax

Practice location:
  • Phone: 334-288-8358
  • Fax:
Mailing address:
  • Phone: 901-634-1428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12779
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: