Healthcare Provider Details
I. General information
NPI: 1578736161
Provider Name (Legal Business Name): PATSY RHODES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2008
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1033 ROCKY BROOK TRL
BIRMINGHAM AL
35214-1001
US
IV. Provider business mailing address
1033 ROCKYBROOK TRAIL
BIRMINGHAM AL
35214
US
V. Phone/Fax
- Phone: 205-674-1626
- Fax: 205-674-1999
- Phone: 205-674-1626
- Fax: 205-674-1999
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | 08006183 |
| License Number State | AL |
VIII. Authorized Official
Name: MS.
PATSY
G
RHODES
Title or Position: OWNER
Credential: CERTIFIED CONSULTANT
Phone: 205-674-1626