Provider Demographics
NPI:1316356363
Name:KINSMAN, ALLYSON HIPP (DPT)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:HIPP
Last Name:KINSMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:KRISTEN
Other - Last Name:HIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:803-791-2203
Mailing Address - Fax:
Practice Address - Street 1:123 E MEDICAL LN
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4813
Practice Address - Country:US
Practice Address - Phone:803-791-2397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400104672225100000X
SC11906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist