Provider Demographics
NPI:1003248022
Name:WILLIAMS, ALLEN KOHL III (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:KOHL
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 COMPLEX DR
Mailing Address - Street 2:
Mailing Address - City:WYALUSING
Mailing Address - State:PA
Mailing Address - Zip Code:18853-7803
Mailing Address - Country:US
Mailing Address - Phone:570-746-0504
Mailing Address - Fax:570-746-0470
Practice Address - Street 1:42 COMPLEX DR
Practice Address - Street 2:
Practice Address - City:WYALUSING
Practice Address - State:PA
Practice Address - Zip Code:18853-7803
Practice Address - Country:US
Practice Address - Phone:570-746-0504
Practice Address - Fax:570-746-0470
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist