Provider Demographics
NPI:1649401571
Name:ALLISON, ASHLEY CATHLEEN (PTA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CATHLEEN
Last Name:ALLISON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 S KOHLER RD
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-9688
Mailing Address - Country:US
Mailing Address - Phone:330-317-9180
Mailing Address - Fax:
Practice Address - Street 1:1615 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2335
Practice Address - Country:US
Practice Address - Phone:330-601-0980
Practice Address - Fax:330-601-0970
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06508225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant