Provider Demographics
NPI:1396087896
Name:O'BANION, ALYSON KIRKLAND (MPT)
Entity type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:KIRKLAND
Last Name:O'BANION
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1220 W WHEELER PKWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6625
Mailing Address - Country:US
Mailing Address - Phone:706-446-1399
Mailing Address - Fax:706-210-2036
Practice Address - Street 1:1220 W WHEELER PKWY
Practice Address - Street 2:SUITE E
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6625
Practice Address - Country:US
Practice Address - Phone:706-446-1399
Practice Address - Fax:706-210-2036
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006389225100000X
SC3853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist