Provider Demographics
NPI:1912320003
Name:MARTY, ALISON E (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:E
Last Name:MARTY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:E
Other - Last Name:MULCAHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:8402 CENTENNIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4792
Mailing Address - Country:US
Mailing Address - Phone:702-731-1616
Mailing Address - Fax:702-294-7494
Practice Address - Street 1:8402 CENTENNIAL PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4792
Practice Address - Country:US
Practice Address - Phone:702-731-1616
Practice Address - Fax:702-294-7494
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3305225100000X
RIPT02666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist