Provider Demographics
NPI:1942448824
Name:MCCARTHY, ALISON L (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:L
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:L
Other - Last Name:MCMILLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:15425 MANCHESTER RD STE 28
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3077
Mailing Address - Country:US
Mailing Address - Phone:636-220-6969
Mailing Address - Fax:636-220-6973
Practice Address - Street 1:15425 MANCHESTER RD STE 28
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-3077
Practice Address - Country:US
Practice Address - Phone:636-220-6969
Practice Address - Fax:636-220-6973
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008036992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist