Provider Demographics
NPI:1194788588
Name:SCHUCKERT, ALLYSON KAHEALANI (ATC)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:KAHEALANI
Last Name:SCHUCKERT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-0804
Mailing Address - Country:US
Mailing Address - Phone:808-885-4433
Mailing Address - Fax:808-775-8803
Practice Address - Street 1:45-527 PAKALANA ST
Practice Address - Street 2:
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727-6986
Practice Address - Country:US
Practice Address - Phone:808-775-8800
Practice Address - Fax:808-775-8803
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer