Healthcare Provider Details

I. General information

NPI: 1124784855
Provider Name (Legal Business Name): P4 PHYSICAL THERAPY-HWY 280, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 NARROWS PKWY
BIRMINGHAM AL
35242-8603
US

IV. Provider business mailing address

8059 MITCHELL LN
VESTAVIA HILLS AL
35216-6821
US

V. Phone/Fax

Practice location:
  • Phone: 205-719-2420
  • Fax: 205-719-2468
Mailing address:
  • Phone: 205-607-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE SMITH
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 205-531-4200