Basic Information
Provider Information
NPI: 1205266517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMETT
FirstName: ALLISON
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 242037
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361242037
CountryCode: US
TelephoneNumber: 3343963273
FaxNumber: 3343964905
Practice Location
Address1: 249 MACK BAYOU LOOP
Address2: SUITE 101
City: SANTA ROSA BEACH
State: FL
PostalCode: 324597198
CountryCode: US
TelephoneNumber: 8506220838
FaxNumber: 8506225880
Other Information
ProviderEnumerationDate: 11/22/2013
LastUpdateDate: 11/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT28769FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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