Provider Demographics
NPI:1972307569
Name:ROAN, ALLISON ELISE (PT, DPT, CES)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:ELISE
Last Name:ROAN
Suffix:
Gender:
Credentials:PT, DPT, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 RAYMOND ODOM RD
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-8275
Mailing Address - Country:US
Mailing Address - Phone:318-355-5265
Mailing Address - Fax:
Practice Address - Street 1:409 1ST ST
Practice Address - Street 2:
Practice Address - City:BERNICE
Practice Address - State:LA
Practice Address - Zip Code:71222-4001
Practice Address - Country:US
Practice Address - Phone:318-285-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist