Provider Demographics
NPI:1417948050
Name:WALIMA ALLRED, REBECCA L (PT DPT)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:L
Last Name:WALIMA ALLRED
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BEACH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1468
Mailing Address - Country:US
Mailing Address - Phone:978-526-8288
Mailing Address - Fax:978-526-7084
Practice Address - Street 1:40 BEACH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1468
Practice Address - Country:US
Practice Address - Phone:978-526-8288
Practice Address - Fax:978-526-7084
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69614Medicare ID - Type UnspecifiedPHYSICAL THERAPIST