Healthcare Provider Details

I. General information

NPI: 1285123729
Provider Name (Legal Business Name): ALLISON ANN HILBOLDT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON ANN SECK PT, DPT

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 12/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17134 BEL RAY PL
BELTON MO
64012-5331
US

IV. Provider business mailing address

6397 LEE HWY STE 300
CHATTANOOGA TN
37421-2564
US

V. Phone/Fax

Practice location:
  • Phone: 816-318-0434
  • Fax: 816-318-0437
Mailing address:
  • Phone: 423-238-7217
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-5751
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-06054
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2018022257
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: