Provider Demographics
NPI:1336355767
Name:CHARLES, ALLISON LEE (PT)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:LEE
Last Name:CHARLES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6535 BUENA VISTA CT
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-9416
Mailing Address - Country:US
Mailing Address - Phone:828-757-6126
Mailing Address - Fax:
Practice Address - Street 1:1031 MORGANTON BLVD SW
Practice Address - Street 2:QUEST 4 LIFE REHABILITATION SERVICES
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5669
Practice Address - Country:US
Practice Address - Phone:828-757-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC137GJOtherBLUE CROSS BLUE SHIELD NC