Provider Demographics
NPI:1992979827
Name:ALIINGTON, JOANN GARY (PT)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:GARY
Last Name:ALIINGTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:PETERSON
Other - Last Name:GARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:606 CRESTVIEW PLACE
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906
Mailing Address - Country:US
Mailing Address - Phone:765-491-0247
Mailing Address - Fax:765-464-3586
Practice Address - Street 1:606 CRESTVIEW PL
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-2312
Practice Address - Country:US
Practice Address - Phone:765-491-0247
Practice Address - Fax:765-464-3586
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006593A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200650720Medicaid