Healthcare Provider Details

I. General information

NPI: 1073619227
Provider Name (Legal Business Name): INTEGRITY SPORTS MEDICINE & REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 DAHLKE DR
CULLMAN AL
35058-3625
US

IV. Provider business mailing address

1811 DAHLKE DR
CULLMAN AL
35058-3625
US

V. Phone/Fax

Practice location:
  • Phone: 256-739-1370
  • Fax: 256-739-1956
Mailing address:
  • Phone: 256-739-1370
  • Fax: 256-739-1956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LEAH HASSELL
Title or Position: CBO MANAGER
Credential: CPC
Phone: 256-736-8875