Provider Demographics
NPI:1356722607
Name:EUDY, ALLISON BELL (PT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:BELL
Last Name:EUDY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 VAN BUREN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5541
Mailing Address - Country:US
Mailing Address - Phone:704-628-6053
Mailing Address - Fax:704-628-6702
Practice Address - Street 1:1001 VAN BUREN AVE STE 3
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5541
Practice Address - Country:US
Practice Address - Phone:704-628-6053
Practice Address - Fax:704-628-6702
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003339225100000X
SC7785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist