Individual
MS. MARY A. ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
20 N WOODBURY TURNERSVILLE RD, BLACKWOOD, NJ 08012-2888
(856) 374-6665
Mailing address
14 SHANNON LANE, WINSLOW, NJ 08095
(609) 567-0669
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00092500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QB00092500
STATE LICENSE
NJ
Enumeration date
05/03/2007
Last updated
07/08/2007
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