Provider Demographics
NPI:1881719623
Name:ALLEN, LANA KAY (PT)
Entity type:Individual
Prefix:MRS
First Name:LANA
Middle Name:KAY
Last Name:ALLEN
Suffix:
Gender:
Credentials:PT
Other - Prefix:MRS
Other - First Name:LANA
Other - Middle Name:KAY
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1361 TALL TIMBERS
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75645-8366
Mailing Address - Country:US
Mailing Address - Phone:903-736-4939
Mailing Address - Fax:
Practice Address - Street 1:323 EAST HAWKINS PARKWAY
Practice Address - Street 2:PHYSICAL THERAPY
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605
Practice Address - Country:US
Practice Address - Phone:903-544-6930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1105500225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist