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General NPI Number Information
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NPI Number | 1699638734
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Entity Type | Individual
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Provider Name | ALLEN MA PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 15971 STERLING HWY STE A
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City | NINILCHIK
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State | AK
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Zip | 99639
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Country | US
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Telephone | 907-420-0836
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Fax | 907-420-0837
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Provider Business Mailing Address
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Address Line | 10470 KATRINA BLVD, NINILCHIK, AK 99639 UNIT 748
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City | NINILCHIK
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State | AK
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Zip | 99639
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 246688
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License Number State | AK
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