Provider Demographics
NPI:1659512572
Name:MASKELL, ALISON WRIGHT (DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:WRIGHT
Last Name:MASKELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2799 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2531
Mailing Address - Country:US
Mailing Address - Phone:770-491-0920
Mailing Address - Fax:770-491-0906
Practice Address - Street 1:2799 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2531
Practice Address - Country:US
Practice Address - Phone:770-491-0920
Practice Address - Fax:770-491-0906
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT9580225100000X
NCP13901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I657703Medicare PIN