Provider Demographics
NPI:1366155822
Name:FINCH, ALLIE D (DPT)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:D
Last Name:FINCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:D
Other - Last Name:MANGUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 E CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4549
Mailing Address - Country:US
Mailing Address - Phone:928-600-3787
Mailing Address - Fax:
Practice Address - Street 1:601 HORIZON PL
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1915
Practice Address - Country:US
Practice Address - Phone:928-600-3787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-013647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist