Individual
ALLISON LORRAINE KENEALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
201 E HAMILTON AVE, CAMPBELL, CA 95008-0206
(408) 376-0900
Mailing address
1153 STAFFORD DR, CUPERTINO, CA 95014-4968
(781) 883-0190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11473
MA
225100000X
Physical Therapist
PT01782
RI
225100000X
Physical Therapist
Primary
PT291049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0398314
—
MA
Enumeration date
11/29/2006
Last updated
03/01/2017
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