Healthcare Provider Details

I. General information

NPI: 1851527865
Provider Name (Legal Business Name): HEATHER SELLERS M.S. PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CENTURY PARK S SUITE 128
BIRMINGHAM AL
35226-3943
US

IV. Provider business mailing address

3952 VILLAGE CENTER DR
HOOVER AL
35226-6324
US

V. Phone/Fax

Practice location:
  • Phone: 205-823-1215
  • Fax:
Mailing address:
  • Phone: 205-515-1742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPTH5026
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: