Provider Demographics
NPI:1750198537
Name:KOHLER, ALLAN SCOTT (CNS, LCMT)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:SCOTT
Last Name:KOHLER
Suffix:
Gender:M
Credentials:CNS, LCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-3030
Mailing Address - Country:US
Mailing Address - Phone:312-358-4507
Mailing Address - Fax:
Practice Address - Street 1:301 N BARCELONA ST STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-4834
Practice Address - Country:US
Practice Address - Phone:850-466-8959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227022256225700000X
FLMA90497225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist