Provider Demographics
NPI:1457940520
Name:NEAL, ALLYSON (CPHT)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6716
Mailing Address - Country:US
Mailing Address - Phone:865-482-0345
Mailing Address - Fax:
Practice Address - Street 1:854 MAIN ST
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6716
Practice Address - Country:US
Practice Address - Phone:865-482-0345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45114183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician