Provider Demographics
NPI:1225602154
Name:CRUIKSHANK, ALLYSON (LMT)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:CRUIKSHANK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALLYSON CRUIKSHANK
Mailing Address - Street 2:280 AYER RD
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451
Mailing Address - Country:US
Mailing Address - Phone:978-501-6915
Mailing Address - Fax:
Practice Address - Street 1:280 AYER RD
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1160
Practice Address - Country:US
Practice Address - Phone:978-501-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2331225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist