Provider Demographics
NPI:1265842322
Name:RICE, ALLISON (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10320 E 250 N
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46117
Mailing Address - Country:US
Mailing Address - Phone:317-936-5595
Mailing Address - Fax:
Practice Address - Street 1:10320 E 250 N
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46117
Practice Address - Country:US
Practice Address - Phone:317-936-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20000060842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer