Healthcare Provider Details

I. General information

NPI: 1407300742
Provider Name (Legal Business Name): ALLEN WEEKS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 S 20TH ST STE 100
MILWAUKEE WI
53215
US

IV. Provider business mailing address

1254 SE CENTURY DR
LEES SUMMIT MO
64081-3286
US

V. Phone/Fax

Practice location:
  • Phone: 414-645-1984
  • Fax:
Mailing address:
  • Phone: 816-524-1442
  • Fax: 816-524-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2019046296
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number13386-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: