Provider Demographics
NPI:1669707535
Name:ALLEN, KERRY ELIZABETH (DPT)
Entity type:Individual
Prefix:MS
First Name:KERRY
Middle Name:ELIZABETH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W DE LEON ST
Mailing Address - Street 2:APARTMENT B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2745
Mailing Address - Country:US
Mailing Address - Phone:305-323-3546
Mailing Address - Fax:
Practice Address - Street 1:611 W DE LEON ST
Practice Address - Street 2:APARTMENT B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2745
Practice Address - Country:US
Practice Address - Phone:305-323-3546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT22978174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist