Provider Demographics
NPI:1043531387
Name:WALLINGTON, ALEACHA FAITH (DPT)
Entity Type:Individual
Prefix:
First Name:ALEACHA
Middle Name:FAITH
Last Name:WALLINGTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEACHA
Other - Middle Name:FAITH
Other - Last Name:MCCLINTIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2240 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1239
Mailing Address - Country:US
Mailing Address - Phone:304-525-4445
Mailing Address - Fax:304-529-7449
Practice Address - Street 1:2240 5TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-1239
Practice Address - Country:US
Practice Address - Phone:304-525-4445
Practice Address - Fax:304-529-7449
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist