Allen Kohl Williams III, PT, DPT

Individual provider Active NPI Physical Therapist · Wyalusing, PA

NPI 1003248022 · NPPES record last updated Aug 1, 2013

Key facts

NPI
1003248022
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT022826 (PA)
Practice address
42 Complex Dr
Wyalusing, PA 18853-7803
Phone
(570) 746-0504
Fax
(570) 746-0470
NPI assigned
Aug 1, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT022826PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist Past
since Apr 1, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT022826 PA Yes

Addresses

Primary practice location

42 Complex Dr
Wyalusing, PA 18853-7803

Mailing address

42 Complex Dr
Wyalusing, PA 18853-7803
Phone (570) 746-0504

Other providers in Wyalusing, PA

All providers in Wyalusing, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.