Provider Demographics
NPI:1548578487
Name:ALLISON, TONI L M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:L M
Last Name:ALLISON
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 1:30 W MERRIMAC AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-5376
Mailing Address - Country:US
Mailing Address - Phone:435-709-8526
Mailing Address - Fax:
Practice Address - Street 1:30 W MERRIMAC AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5376
Practice Address - Country:US
Practice Address - Phone:435-709-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009936225100000X
UT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist