Provider Demographics
NPI:1316631872
Name:SPAGNOLO, ALISON LYNN (DPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LYNN
Last Name:SPAGNOLO
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LYNN
Other - Last Name:NOGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3900 N PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6398
Mailing Address - Country:US
Mailing Address - Phone:479-966-4187
Mailing Address - Fax:479-966-4197
Practice Address - Street 1:3900 N PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6398
Practice Address - Country:US
Practice Address - Phone:479-966-4187
Practice Address - Fax:579-966-4197
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist