Provider Demographics
NPI:1972346765
Name:REDDEL, ALLISON JUDITH (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JUDITH
Last Name:REDDEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 CINNAMON DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1431
Mailing Address - Country:US
Mailing Address - Phone:402-681-4297
Mailing Address - Fax:
Practice Address - Street 1:10730 PACIFIC ST STE 210
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4761
Practice Address - Country:US
Practice Address - Phone:402-753-7230
Practice Address - Fax:402-932-4926
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist