Provider Demographics
NPI:1225381510
Name:THORNTON, ALLI MCKAY (PT, DPT, ATC, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ALLI
Middle Name:MCKAY
Last Name:THORNTON
Suffix:
Gender:F
Credentials:PT, DPT, ATC, CSCS
Other - Prefix:DR
Other - First Name:ALLI
Other - Middle Name:ELIZABETH
Other - Last Name:MCKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC, CSCS
Mailing Address - Street 1:14618 HALLOWS GRV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2328
Mailing Address - Country:US
Mailing Address - Phone:703-622-3767
Mailing Address - Fax:
Practice Address - Street 1:7909 PAT BOOKER RD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2602
Practice Address - Country:US
Practice Address - Phone:210-653-2400
Practice Address - Fax:210-653-2422
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1224858225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist