Basic Information
| Provider Information | |||||||||
| NPI: | 1952897837 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLISON | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1744 WYOMING AVE | ||||||||
| Address2: | |||||||||
| City: | EAST LIVERPOOL | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439201575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303856576 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9955 UNION RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444559763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309530243 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2018 | ||||||||
| LastUpdateDate: | 07/03/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 142808 | OH | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.