Provider Demographics
NPI:1871881987
Name:ALLEN, FRANK C (LMP)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:C
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7215
Mailing Address - Country:US
Mailing Address - Phone:208-929-2525
Mailing Address - Fax:208-773-0746
Practice Address - Street 1:415 W 15TH AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7215
Practice Address - Country:US
Practice Address - Phone:208-929-2525
Practice Address - Fax:208-773-0746
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60200957225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist