Provider Demographics
NPI:1083179683
Name:BALL, ALLISON ELAINE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:ELAINE
Last Name:BALL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 CLEBURNE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-3400
Mailing Address - Country:US
Mailing Address - Phone:682-235-3816
Mailing Address - Fax:
Practice Address - Street 1:2901 CLEBURNE RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-3400
Practice Address - Country:US
Practice Address - Phone:682-235-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1314421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist