Basic Information
| Provider Information | |||||||||
| NPI: | 1144606831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOZNIAK | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | WIEST | ||||||||
| OtherFirstName: | ALLISON | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 475 ALLENDALE RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | KING OF PRUSSIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194061495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152700370 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 101 OLD YORK RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | JENKINTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190463911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158865520 | ||||||||
| FaxNumber: | 2158865523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2015 | ||||||||
| LastUpdateDate: | 05/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT024507 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251X0800X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.