Provider Demographics
NPI:1639224108
Name:ALISON, RENAE J (RPT)
Entity Type:Individual
Prefix:MRS
First Name:RENAE
Middle Name:J
Last Name:ALISON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 N HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-9500
Mailing Address - Country:US
Mailing Address - Phone:620-327-2834
Mailing Address - Fax:
Practice Address - Street 1:625 N CARRIAGE PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4510
Practice Address - Country:US
Practice Address - Phone:316-684-8735
Practice Address - Fax:316-683-2128
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist