MEDICARE: REBECCA CORBMAN BALLARD DPT

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	225100000X	Physical Therapist	PTH7975	AL

General Provider Information

NPI Number	:	1366985756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA CORBMAN BALLARD DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 FIELDSTOWN RD STE 108
Second Line	:
City	:	GARDENDALE
State	:	AL
Zip	:	35071-2418
Country	:	US
Telephone Number	:	205-285-2180
Fax Number	:	205-285-2181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2016
Last Update Date	:	09/18/2024

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Directions to “ REBECCA CORBMAN BALLARD DPT” Practice Location

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