Jimmie Paul Allen, DPT

Individual provider Active NPI Physical Therapist · Mountain Green, UT

NPI 1285069005 · NPPES record last updated Sep 11, 2013

Key facts

NPI
1285069005
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
281326-2401 (UT)
Practice address
4223 Iris Ave
Mountain Green, UT 84050-9738
Phone
(801) 589-9290
NPI assigned
Sep 11, 2013
Sex
Male
Sole proprietor
Yes

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
281326-2401UTMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 281326-2401 UT Yes

Addresses

Primary practice location

4223 Iris Ave
Mountain Green, UT 84050-9738

Mailing address

4223 Iris Ave
Mountain Green, UT 84050-9738
Phone (801) 589-9290

Other providers in Mountain Green, UT

All providers in Mountain Green, UT · Physical Therapist in Utah

Sources for this page

Verify at the official NPI Registry.