Healthcare Provider Details

I. General information

NPI: 1174443501
Provider Name (Legal Business Name): EMBODIED PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 E TENNESSEE ST
FLORENCE AL
35630-5806
US

IV. Provider business mailing address

618 E TENNESSEE ST
FLORENCE AL
35630-5806
US

V. Phone/Fax

Practice location:
  • Phone: 256-441-7795
  • Fax: 256-615-8684
Mailing address:
  • Phone: 256-441-7795
  • Fax: 256-615-8684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. EMILY CAROLINE KIRKSEY
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 256-441-7795