Provider Demographics
NPI:1790020980
Name:WAIBEL, ALISON KATHLEEN (LMT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:KATHLEEN
Last Name:WAIBEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 N OLSEN AVE
Mailing Address - Street 2:#1
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2846
Mailing Address - Country:US
Mailing Address - Phone:520-302-9840
Mailing Address - Fax:
Practice Address - Street 1:3021 N OLSEN AVE
Practice Address - Street 2:#1
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2846
Practice Address - Country:US
Practice Address - Phone:520-302-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-05946172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist