Provider Demographics
NPI:1649754656
Name:KELLAWAY, ALLISON ANNE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:ANNE
Last Name:KELLAWAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 SPORTS VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3505
Mailing Address - Country:US
Mailing Address - Phone:214-687-9374
Mailing Address - Fax:
Practice Address - Street 1:6025 SPORTS VILLAGE RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3505
Practice Address - Country:US
Practice Address - Phone:214-687-9374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1310523225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist