Provider Demographics
NPI:1083879126
Name:ALLEN, NORA KAY (PTA)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:KAY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67767 ALLEN LN
Mailing Address - Street 2:
Mailing Address - City:LORE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43755-9793
Mailing Address - Country:US
Mailing Address - Phone:174-048-9538
Mailing Address - Fax:
Practice Address - Street 1:67767 ALLEN LN
Practice Address - Street 2:
Practice Address - City:LORE CITY
Practice Address - State:OH
Practice Address - Zip Code:43755-9793
Practice Address - Country:US
Practice Address - Phone:174-048-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01755225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant