Provider Demographics
NPI:1770824443
Name:ATHERTON, ALLISON JOY (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:JOY
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:502 E PIKES PEAK AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3611
Mailing Address - Country:US
Mailing Address - Phone:719-473-2958
Mailing Address - Fax:719-473-1004
Practice Address - Street 1:3455 CANYON DE FLORES STE B
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85650-5380
Practice Address - Country:US
Practice Address - Phone:520-803-9727
Practice Address - Fax:520-378-2683
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0011967225100000X
AZ31346225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist