Healthcare Provider Details

I. General information

NPI: 1497197248
Provider Name (Legal Business Name): THERAPY SOUTH TRUSSVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 GADSDEN HWY STE 116
BIRMINGHAM AL
35235-3162
US

IV. Provider business mailing address

2823 GREYSTONE COMMERCIAL BLVD
BIRMINGHAM AL
35242-2660
US

V. Phone/Fax

Practice location:
  • Phone: 205-655-1921
  • Fax: 205-655-4299
Mailing address:
  • Phone: 205-745-3660
  • Fax: 205-745-3649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN FOSTER
Title or Position: CEO
Credential:
Phone: 205-745-3650