Provider Demographics
NPI:1558705608
Name:ALLISON, AMY JO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:ALLISON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2501 LAKESIDE PKWY APT 104
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4178
Mailing Address - Country:US
Mailing Address - Phone:918-384-8896
Mailing Address - Fax:469-253-6140
Practice Address - Street 1:2621 SUMMIT AVE STE 500
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-3748
Practice Address - Country:US
Practice Address - Phone:918-384-8896
Practice Address - Fax:469-253-6140
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12204102251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic