Provider Demographics
NPI:1124989314
Name:ALISON EDWARDS PHYSICAL THERAPY AND PERFORMANCE
Entity type:Organization
Organization Name:ALISON EDWARDS PHYSICAL THERAPY AND PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:970-331-3777
Mailing Address - Street 1:6521 1/2 LELAND WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7812
Mailing Address - Country:US
Mailing Address - Phone:970-331-3777
Mailing Address - Fax:
Practice Address - Street 1:9200 W SUNSET BLVD STE 170
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3615
Practice Address - Country:US
Practice Address - Phone:970-331-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty