Provider Demographics
NPI:1376836494
Name:HELMLE, ALISON MARIE (MSPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIE
Last Name:HELMLE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CLAIRE WAY
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2041
Mailing Address - Country:US
Mailing Address - Phone:415-320-3344
Mailing Address - Fax:
Practice Address - Street 1:247 SHORELINE HWY
Practice Address - Street 2:SUITE A9
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3664
Practice Address - Country:US
Practice Address - Phone:415-381-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37762225100000X
MA15868225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist