Healthcare Provider Details

I. General information

NPI: 1881316164
Provider Name (Legal Business Name): A HEALING PLACE BHAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 23RD ST S STE 381
BIRMINGHAM AL
35205-2499
US

IV. Provider business mailing address

1709 13TH AVE S APT A
BIRMINGHAM AL
35205-5590
US

V. Phone/Fax

Practice location:
  • Phone: 205-224-2115
  • Fax:
Mailing address:
  • Phone: 205-224-2115
  • 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: ALYSSA SHEDLARSKI
Title or Position: CEO
Credential: DPT
Phone: 205-224-2115