Provider Demographics
NPI:1053208488
Name:NEAL, ALLIE DUNN (LPTA)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:DUNN
Last Name:NEAL
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PROFESSIONAL PL
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-2756
Mailing Address - Country:US
Mailing Address - Phone:662-477-0716
Mailing Address - Fax:
Practice Address - Street 1:103 PROFESSIONAL PL
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-2756
Practice Address - Country:US
Practice Address - Phone:662-477-0716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPTA7474225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant