Healthcare Provider Details

I. General information

NPI: 1447482021
Provider Name (Legal Business Name): ALLISON L. VANCE MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON L. SCHEUREN MSPT

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 S GARFIELD AVE
FRACKVILLE PA
17931-2427
US

IV. Provider business mailing address

649 S GARFIELD AVE
FRACKVILLE PA
17931-2427
US

V. Phone/Fax

Practice location:
  • Phone: 570-874-2125
  • Fax: 570-874-4019
Mailing address:
  • Phone: 570-874-2125
  • Fax: 570-874-4019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019412
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: