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General NPI Number Information
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NPI Number | 1265063655
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Entity Type | Individual
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Provider Name | ALLISON JO DAVID DC, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 600 N COLLEGE AVE
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City | GENESEO
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State | IL
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Zip | 61254-1099
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Country | US
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Telephone | 309-944-6431
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 8TH STREET CT
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City | HAMPTON
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State | IL
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Zip | 61256-9608
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 038014223
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096005634
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038014223
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License Number State | IL
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