Provider Demographics
NPI:1285762310
Name:ALLISON, LINDA L (PTA0713)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:L
Last Name:ALLISON
Suffix:
Gender:F
Credentials:PTA0713
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:L
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1046 WILDCAT RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583
Mailing Address - Country:US
Mailing Address - Phone:931-761-2801
Mailing Address - Fax:
Practice Address - Street 1:825 FISHER
Practice Address - Street 2:NHC
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166
Practice Address - Country:US
Practice Address - Phone:615-597-4284
Practice Address - Fax:615-597-0734
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0713225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant