Provider Demographics
NPI:1447467527
Name:VAN ALLEN, JOSEPH JENS (MSPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JENS
Last Name:VAN ALLEN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 OAK KNOLL DR.
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760
Mailing Address - Country:US
Mailing Address - Phone:508-384-9109
Mailing Address - Fax:
Practice Address - Street 1:1 PATRIOT PL
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1374
Practice Address - Country:US
Practice Address - Phone:508-384-9109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16036225100000X
MA14632255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer