Provider Demographics
NPI:1649822834
Name:ALLEN, HALEY KING (PT)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:KING
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:A
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4601 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2290
Mailing Address - Country:US
Mailing Address - Phone:704-323-2248
Mailing Address - Fax:
Practice Address - Street 1:15825 BALLANTYNE MEDICAL PL STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4790
Practice Address - Country:US
Practice Address - Phone:704-323-3409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist