Healthcare Provider Details

I. General information

NPI: 1437079415
Provider Name (Legal Business Name): REFINE PT AND PERFORMANCE - FAIRHOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22806A US HIGHWAY 98
FAIRHOPE AL
36532-3328
US

IV. Provider business mailing address

108 S FLORIDA ST
MOBILE AL
36606-1927
US

V. Phone/Fax

Practice location:
  • Phone: 251-501-2700
  • Fax:
Mailing address:
  • Phone:
  • 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: KYLE THIBODEAUX
Title or Position: OWNER
Credential: PT, DPT, OCS, CSCS
Phone: 251-501-2700