Provider Demographics
NPI:1245332113
Name:FOWLKES, ALLISON W (PT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:W
Last Name:FOWLKES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MONTEVALLO LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-4403
Mailing Address - Country:US
Mailing Address - Phone:205-870-7095
Mailing Address - Fax:
Practice Address - Street 1:2807 GREYSTONE COMMERCIAL BLVD
Practice Address - Street 2:SUITE 32
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6585
Practice Address - Country:US
Practice Address - Phone:205-408-1713
Practice Address - Fax:205-408-1170
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist