Provider Demographics
NPI:1265637417
Name:MOORE, ALLISON M (DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:MOORE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:MILLOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3809 CREST LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2392
Mailing Address - Country:US
Mailing Address - Phone:858-226-9804
Mailing Address - Fax:858-226-9804
Practice Address - Street 1:3809 CREST LN
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2392
Practice Address - Country:US
Practice Address - Phone:858-226-9804
Practice Address - Fax:858-226-9804
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CAPT33758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist