Healthcare Provider Details

I. General information

NPI: 1295511459
Provider Name (Legal Business Name): MICHAEL JOHN ALPUERTO BADIOLA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 9TH AVE SW
BESSEMER AL
35022-4502
US

IV. Provider business mailing address

650 9TH AVE SW
BESSEMER AL
35022-4502
US

V. Phone/Fax

Practice location:
  • Phone: 205-425-5428
  • Fax:
Mailing address:
  • Phone: 205-425-5428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH7131
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: