Healthcare Provider Details

I. General information

NPI: 1912520115
Provider Name (Legal Business Name): MAGIC CITY PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 WILLOW LEAF CIRCLE
BIRMINGHAM AL
35244
US

IV. Provider business mailing address

1217 WILLOW LEAF CIR
HOOVER AL
35244-4131
US

V. Phone/Fax

Practice location:
  • Phone: 205-602-1848
  • Fax:
Mailing address:
  • Phone: 205-602-1848
  • Fax: 205-293-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER SELF SPENCER
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 205-602-1848