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NPI Code Detail

MEDICARE: PATRICIA MARIE ALLSHOUSE PTA

MEDICARE:   PATRICIA MARIE ALLSHOUSE  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
1225200000XPhysical Therapy Assistant160.002157IL

General Provider Information

NPI Number : 1215207915
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA MARIE ALLSHOUSE PTA
Provider Business Mailing Address
First Line : 409 10TH AVE
Second Line :
City : HAMPTON
State : IL
Zip : 61256-9617
Country : US
Telephone Number : 309-269-7630
Fax Number :
Provider Business Practice Location Address
First Line : 2545 24TH ST
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-5305
Country : US
Telephone Number : 309-788-5234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2012
Last Update Date : 01/11/2012

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Directions to “ PATRICIA MARIE ALLSHOUSE PTA” Practice Location

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