Provider Demographics
NPI:1285939090
Name:ALLISON, HARRY
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:ALLISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 SW COQUINA COVE WAY
Mailing Address - Street 2:202
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3821 SW COQUINA COVE WAY
Practice Address - Street 2:202
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-8177
Practice Address - Country:US
Practice Address - Phone:561-790-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1634171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist