Healthcare Provider Details

I. General information

NPI: 1881219541
Provider Name (Legal Business Name): KELLIE ANNE MCCAFFREY VINEYARD PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 MEDICAL CENTER DR
BESSEMER AL
35022-6028
US

IV. Provider business mailing address

39 HORN BEAM WAY
SANTA ROSA BEACH FL
32459-8414
US

V. Phone/Fax

Practice location:
  • Phone: 205-481-7125
  • Fax:
Mailing address:
  • Phone: 334-796-1282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: