Healthcare Provider Details

I. General information

NPI: 1336845239
Provider Name (Legal Business Name): PHYSIOBABY PHYSICAL THERAPY & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CAHABA PARK CIR STE 400
BIRMINGHAM AL
35242-8130
US

IV. Provider business mailing address

201 CAHABA PARK CIR STE 400
BIRMINGHAM AL
35242-8130
US

V. Phone/Fax

Practice location:
  • Phone: 205-634-2115
  • Fax: 832-412-2983
Mailing address:
  • Phone: 205-634-2115
  • Fax: 832-412-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE M DOUGHERTY
Title or Position: OWNER
Credential: PT, DPT
Phone: 205-634-2115