Provider Demographics
NPI:1225168982
Name:SMITH, ALLISON NICOLE (PT, DPT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 TERON TRCE STE 200
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1666
Mailing Address - Country:US
Mailing Address - Phone:404-785-8902
Mailing Address - Fax:
Practice Address - Street 1:2108 TERON TRCE STE 200
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1666
Practice Address - Country:US
Practice Address - Phone:404-785-8902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0013812255A2300X
GAPT008989225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer