Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 9978 | AZ |
NPI | 1003165556 |
---|---|
Provider Name | Allison Tansley |
First Address | Chandler, AZ 85224 |
Second Address | Chandler, AZ 85224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2012 |
Last Update Date | 20/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
736892 | (05) | AZ |