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General NPI Number Information
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NPI Number | 1588729370
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Entity Type | Individual
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Provider Name | ALYSON KIERNAN PT, MS
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Gender | Female
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 1329 E HWY 89A STE. D
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4506
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Country | US
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Telephone | 928-634-1900
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Fax | 928-634-1906
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Provider Business Mailing Address
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Address Line | 216 N MATANZAS AVE
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City | TAMPA
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State | FL
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Zip | 33609
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Country | US
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Telephone | 928-300-0296
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Fax | 928-634-1906
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5772
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License Number State | AZ
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