MEDICARE: DAKOTA ALLEN

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	225100000X	Physical Therapist	1365039	TX

General Provider Information

NPI Number	:	1740024488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKOTA ALLEN

Provider Business Mailing Address
First Line	:	108 W OAK AVE
Second Line	:
City	:	COMANCHE
State	:	TX
Zip	:	76442-3273
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 W OAK AVE
Second Line	:
City	:	COMANCHE
State	:	TX
Zip	:	76442-3273
Country	:	US
Telephone Number	:	325-356-7162
Fax Number	:

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

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	06/19/2024

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Directions to “ DAKOTA ALLEN ” Practice Location

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