Provider Demographics
NPI:1932736949
Name:PAYLEITNER, ALLISON (PT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PAYLEITNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N64W26425 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3417
Mailing Address - Country:US
Mailing Address - Phone:262-853-3015
Mailing Address - Fax:
Practice Address - Street 1:531 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2531
Practice Address - Country:US
Practice Address - Phone:262-335-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist