Healthcare Provider Details

I. General information

NPI: 1184118317
Provider Name (Legal Business Name): ENCORE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W MAPLE AVE
GENEVA AL
36340-1642
US

IV. Provider business mailing address

251 JOHNSTON ST SE STE 200
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 334-684-3655
  • Fax:
Mailing address:
  • Phone: 256-350-1764
  • 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: PAUL HENDERSON
Title or Position: PRESIDENT
Credential:
Phone: 256-350-1764