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>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1417502915

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3102 RAINBOW DR STE 200  RAINBOW CITY, AL 35906-5804 US
Tel: 256-549-6387  Fax: 256-549-6391

Contact information for business:
Tel: 423-238-7217  Fax: 423-933-1996

Registration Information:
NPI: 1417502915
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist

Legacy codes, insurance codes and state license numbers:



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