Healthcare Provider Details

I. General information

NPI: 1164787214
Provider Name (Legal Business Name): ENCORE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19195 N 3RD ST
CITRONELLE AL
36522-4015
US

IV. Provider business mailing address

251 JOHNSTON ST SE SUITE 300
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 251-866-0464
  • Fax: 251-866-0466
Mailing address:
  • Phone: 256-340-9708
  • Fax: 256-340-9624

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: PAUL HENDERSON
Title or Position: PRESIDENT
Credential: PT
Phone: 256-350-1764