Provider Demographics
NPI:1053959130
Name:ALLEN, JOHN TANNER (PT,DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TANNER
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12823 WOODMILL DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8945
Mailing Address - Country:US
Mailing Address - Phone:229-740-3484
Mailing Address - Fax:
Practice Address - Street 1:12823 WOODMILL DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8945
Practice Address - Country:US
Practice Address - Phone:229-740-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT35395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist