Provider Demographics
NPI:1477704583
Name:ALLISON, LINDA L (OTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:ALLISON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3496 W 250 S
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-7946
Mailing Address - Country:US
Mailing Address - Phone:765-327-2690
Mailing Address - Fax:
Practice Address - Street 1:3496 W 250 S
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-7946
Practice Address - Country:US
Practice Address - Phone:765-327-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000806A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist