Provider Demographics
NPI:1639516115
Name:IPPOLITO, ALLISON L (DPT, MTC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:IPPOLITO
Suffix:
Gender:F
Credentials:DPT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9170 GALLERIA CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-4399
Mailing Address - Country:US
Mailing Address - Phone:239-594-5412
Mailing Address - Fax:239-594-2853
Practice Address - Street 1:9170 GALLERIA CT
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-4399
Practice Address - Country:US
Practice Address - Phone:239-594-5412
Practice Address - Fax:239-594-2853
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 28258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist