Provider Demographics
NPI:1053889980
Name:ROEHNER, ALISON LEIGH (DPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LEIGH
Last Name:ROEHNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LEIGH
Other - Last Name:ZELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:ID
Mailing Address - Zip Code:83611-1330
Mailing Address - Country:US
Mailing Address - Phone:208-382-3862
Mailing Address - Fax:208-382-3359
Practice Address - Street 1:402 LAKE CASCADE PKWY
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:ID
Practice Address - Zip Code:83611-7702
Practice Address - Country:US
Practice Address - Phone:208-382-3862
Practice Address - Fax:208-382-3359
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-5882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist