Healthcare Provider Details

I. General information

NPI: 1215865779
Provider Name (Legal Business Name): ZACHARY MASON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5518 CRESTWOOD BOULEVARD
BIRMINGHAM AL
35212
US

IV. Provider business mailing address

5518 CRESTWOOD BOULEVARD
BIRMINGHAM AL
35212
US

V. Phone/Fax

Practice location:
  • Phone: 205-201-4245
  • Fax: 205-201-4481
Mailing address:
  • Phone: 205-201-4245
  • Fax: 205-201-4481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12656
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: