Provider Demographics
NPI:1831872381
Name:EDMONSON, ALLYN CLAIRE (DPT)
Entity type:Individual
Prefix:
First Name:ALLYN
Middle Name:CLAIRE
Last Name:EDMONSON
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 1:3893 OVERTON MANOR LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5314
Mailing Address - Country:US
Mailing Address - Phone:601-572-7069
Mailing Address - Fax:
Practice Address - Street 1:7191 CAHABA VALLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-6507
Practice Address - Country:US
Practice Address - Phone:205-408-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist