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NPI 1982402673

NPI 1982402673 : ALLISON HAIR ODEA DPT : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1982402673
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    Entity Type          |    Individual 
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    Provider Name        |    ALLISON HAIR ODEA DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/06/2025
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    Last Update Date     |    03/10/2026
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Provider Practice Location Address
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    Address Line         |    3108 RAEFORD RD STE 100 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28303-6037
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    Country              |    US
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    Telephone            |    910-484-2091
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1200 CORPORATE DR STE 400 
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    City                 |    HOOVER
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    State                |    AL
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    Zip                  |    35242-5424
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    Country              |    US
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    Telephone            |    423-238-7217
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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       |    11979
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    License Number State |    LA
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    P24749
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    License Number State |    NC
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