Healthcare Provider Details

I. General information

NPI: 1427200971
Provider Name (Legal Business Name): ENCORE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13040 N WINTZELL AVE OFFICE # 2
BAYOU LA BATRE AL
36509-2110
US

IV. Provider business mailing address

1908 FLINT RD SE
DECATUR AL
35601-6031
US

V. Phone/Fax

Practice location:
  • Phone: 251-824-2882
  • Fax: 251-824-2884
Mailing address:
  • Phone: 256-350-1764
  • Fax: 256-350-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateAL

VIII. Authorized Official

Name: PAUL G HENDERSON
Title or Position: PRESIDENT
Credential: PT
Phone: 256-350-1764