Provider Demographics
NPI:1649259896
Name:BROWNING GATES, ALLISON (PT1688)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BROWNING GATES
Suffix:
Gender:F
Credentials:PT1688
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 CAMPBELL LN
Mailing Address - Street 2:
Mailing Address - City:TUCKERMAN
Mailing Address - State:AR
Mailing Address - Zip Code:72473-9089
Mailing Address - Country:US
Mailing Address - Phone:870-349-4025
Mailing Address - Fax:
Practice Address - Street 1:2029 CAMPBELL LN
Practice Address - Street 2:
Practice Address - City:TUCKERMAN
Practice Address - State:AR
Practice Address - Zip Code:72473-9089
Practice Address - Country:US
Practice Address - Phone:870-349-4025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA1688225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR138517721Medicaid