Provider Demographics
NPI:1699845909
Name:KESSELRING, ALLISON PALANK (MPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:PALANK
Last Name:KESSELRING
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MARIE
Other - Last Name:PALANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:17 WESTERN MARYLAND PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5471
Mailing Address - Country:US
Mailing Address - Phone:301-797-6389
Mailing Address - Fax:301-797-4119
Practice Address - Street 1:17 WESTERN MARYLAND PKWY
Practice Address - Street 2:100
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5471
Practice Address - Country:US
Practice Address - Phone:301-797-6389
Practice Address - Fax:301-797-4119
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21453225100000X
PAPT023160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00689922OtherRR MEDICARE MD
PAP01286314OtherRR MEDICARE
MD94428301OtherBCBS LOCAL CAREFIRST KG85
MDW2660020OtherBCBS REGIONAL CAREFIRST W266
MD94428301OtherBCBS LOCAL CAREFIRST KG85
MDP00689922OtherRR MEDICARE MD