Provider Demographics
NPI:1164273371
Name:COKER, ALLYSON (PT)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:COKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 FAIRWAY ST
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-6301
Mailing Address - Country:US
Mailing Address - Phone:870-830-5884
Mailing Address - Fax:
Practice Address - Street 1:2024 S BUERKLE ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-6508
Practice Address - Country:US
Practice Address - Phone:870-673-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist