Provider Demographics
NPI:1093897712
Name:HILDRETH, ALLISON (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:HILDRETH
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 1:805 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-1111
Mailing Address - Country:US
Mailing Address - Phone:303-279-9728
Mailing Address - Fax:303-278-0180
Practice Address - Street 1:805 12TH ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1111
Practice Address - Country:US
Practice Address - Phone:303-279-9728
Practice Address - Fax:303-278-0180
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAL670371OtherB/C & B/S PROVIDER ID
COC801201Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER