Provider Demographics
NPI:1295168532
Name:DAVIS, ALLISON CRAVEN (PT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:CRAVEN
Last Name:DAVIS
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 1:16052 FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8876
Mailing Address - Country:US
Mailing Address - Phone:913-897-8960
Mailing Address - Fax:
Practice Address - Street 1:16052 FOSTER ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085-8876
Practice Address - Country:US
Practice Address - Phone:913-897-8960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225100000X
WAPT60359917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1295168532Medicaid
WAG8922515Medicare PIN