Provider Demographics
NPI:1104349596
Name:CLARKE, ALLISON DEAN (DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:DEAN
Last Name:CLARKE
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 VICTORIA WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-4822
Mailing Address - Country:US
Mailing Address - Phone:859-537-7577
Mailing Address - Fax:
Practice Address - Street 1:424 LEWIS HARGETT CIR STE B100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3683
Practice Address - Country:US
Practice Address - Phone:859-475-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00736225100000X, 225100000X
MSPT6263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist