MEDICARE: PRO LEVEL PERFORMANCE & PHYSIO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1093670572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO LEVEL PERFORMANCE & PHYSIO INC

Provider Business Mailing Address
First Line	:	2204 BLUE RIDGE BLVD
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35226-3157
Country	:	US
Telephone Number	:	205-527-3889
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 OFFICE PARK CIR STE 100
Second Line	:
City	:	MOUNTAIN BRK
State	:	AL
Zip	:	35223-2545
Country	:	US
Telephone Number	:	205-527-3889
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MASON MCANNALLY
Credential	:	PT, DPT
Telephone Number	:	205-527-3889

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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