Provider Demographics
NPI:1306979430
Name:ALLEN, KATHRINE (LMT)
Entity type:Individual
Prefix:
First Name:KATHRINE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMT
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 5632
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611-5632
Mailing Address - Country:US
Mailing Address - Phone:352-666-0065
Mailing Address - Fax:352-684-5264
Practice Address - Street 1:12560 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5000
Practice Address - Country:US
Practice Address - Phone:352-666-0065
Practice Address - Fax:352-684-5265
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 26302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC1176OtherBLUE CROSS AND BLUE SHIEL