Provider Demographics
NPI:1831253723
Name:VANHORN, ALISON MICHELE (MSPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MICHELE
Last Name:VANHORN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MICHELE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1181 AQUIDNECK AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5255
Mailing Address - Country:US
Mailing Address - Phone:401-845-0840
Mailing Address - Fax:401-845-0842
Practice Address - Street 1:1181 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5255
Practice Address - Country:US
Practice Address - Phone:401-845-0840
Practice Address - Fax:401-845-0842
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4480225100000X
MA23930225100000X
MD22032225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist