MEDICARE: MS. ESTHER LOUISE ALLEN D.T.

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	174400000X	Specialist	NONE

General Provider Information

NPI Number	:	1477623387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ESTHER LOUISE ALLEN D.T.

Provider Business Mailing Address
First Line	:	2150 NO. TIFFIN
Second Line	:
City	:	WEST TERRE HAUTE
State	:	IN
Zip	:	47885
Country	:	US
Telephone Number	:	812-533-0045
Fax Number	:	812-533-9935

Provider Business Practice Location Address
First Line	:	2150 N. TIFFIN
Second Line	:
City	:	WEST TERRE HAUTE
State	:	IN
Zip	:	47885
Country	:	US
Telephone Number	:	812-533-0045
Fax Number	:	812-533-9935

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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