Provider Demographics
NPI:1437760956
Name:CROOKS, ALLYSON (PTA)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:CROOKS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 W KENNEWICK AVE # 550
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2927
Mailing Address - Country:US
Mailing Address - Phone:509-783-8977
Mailing Address - Fax:
Practice Address - Street 1:299 BRADLEY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4691
Practice Address - Country:US
Practice Address - Phone:509-713-7555
Practice Address - Fax:509-713-7559
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP161066690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist