Basic Information
Provider Information
NPI: 1437517240
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARTIST
FirstName: ALLISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9300 STONESTREET RD
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402722863
CountryCode: US
TelephoneNumber: 5029359776
FaxNumber: 5029359813
Practice Location
Address1: 9300 STONESTREET RD
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402722863
CountryCode: US
TelephoneNumber: 5029359776
FaxNumber: 5029359813
Other Information
ProviderEnumerationDate: 02/08/2016
LastUpdateDate: 10/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH7902ALN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT-008059KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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