Healthcare Provider Details

I. General information

NPI: 1225381510
Provider Name (Legal Business Name): ALLI MCKAY THORNTON PT, DPT, ATC, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLI ELIZABETH MCKAY PT, DPT, ATC, CSCS

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7909 PAT BOOKER RD
LIVE OAK TX
78233-2602
US

IV. Provider business mailing address

14618 HALLOWS GRV
SAN ANTONIO TX
78254-2328
US

V. Phone/Fax

Practice location:
  • Phone: 210-653-2400
  • Fax: 210-653-2422
Mailing address:
  • Phone: 703-622-3767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1224858
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: