MEDICARE: NORA KAY ALLEN PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	01755	OH

General Provider Information

NPI Number	:	1083879126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA KAY ALLEN PTA

Provider Business Mailing Address
First Line	:	67767 ALLEN LN
Second Line	:
City	:	LORE CITY
State	:	OH
Zip	:	43755-9793
Country	:	US
Telephone Number	:	174-048-9538
Fax Number	:

Provider Business Practice Location Address
First Line	:	67767 ALLEN LN
Second Line	:
City	:	LORE CITY
State	:	OH
Zip	:	43755-9793
Country	:	US
Telephone Number	:	174-048-9538
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	07/28/2008

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Directions to “ NORA KAY ALLEN PTA” Practice Location

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