Basic Information
| Provider Information | |||||||||
| NPI: | 1215367412 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUPE | ||||||||
| FirstName: | ALLYSON | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8448 SIEGEN LN | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708101938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257678182 | ||||||||
| FaxNumber: | 2257678757 | ||||||||
| Practice Location | |||||||||
| Address1: | 4570 COUNTY ROAD 61 | ||||||||
| Address2: | |||||||||
| City: | MOOSE LAKE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557679401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2184852020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2013 | ||||||||
| LastUpdateDate: | 08/03/2018 | ||||||||
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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 | 08599 | LA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 10312 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.