Monique Allen

Individual provider Active NPI Physical Therapy Assistant · Dublin, GA

NPI 1073129342 · NPPES record last updated Sep 21, 2020

Key facts

NPI
1073129342
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
002474 (GA)
Practice address
203 S Lancaster St
Dublin, GA 31021-3423
Phone
(478) 304-6005
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
002474GAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 002474 GA Yes

Addresses

Primary practice location

203 S Lancaster St
Dublin, GA 31021-3423

Mailing address

203 S Lancaster St
Dublin, GA 31021-3423
Phone (478) 304-6005

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL MALLEN Direct

Other providers in Dublin, GA

All providers in Dublin, GA · Physical Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.