Provider Demographics
NPI:1356051734
Name:HYATT, ALLISON ELAINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELAINE
Last Name:HYATT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 PIPERS LN
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70665-7006
Mailing Address - Country:US
Mailing Address - Phone:337-309-9504
Mailing Address - Fax:
Practice Address - Street 1:208 PIPERS LN
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70665-7006
Practice Address - Country:US
Practice Address - Phone:337-309-9504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist