Provider Demographics
NPI:1609209527
Name:MACKAY, ALLISON JOY (DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JOY
Last Name:MACKAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4250
Mailing Address - Country:US
Mailing Address - Phone:860-430-8383
Mailing Address - Fax:860-856-6945
Practice Address - Street 1:2520 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4250
Practice Address - Country:US
Practice Address - Phone:860-430-8383
Practice Address - Fax:860-856-6945
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT013546225100000X
MN9463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist