Healthcare Provider Details

I. General information

NPI: 1063421857
Provider Name (Legal Business Name): THERAFIT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12819 HWY 231 431 N SUITE G
HAZEL GREEN AL
35750-8629
US

IV. Provider business mailing address

12819 HWY 231 431 N SUITE G
HAZEL GREEN AL
35750-8629
US

V. Phone/Fax

Practice location:
  • Phone: 256-829-9544
  • Fax: 256-829-9522
Mailing address:
  • Phone: 256-829-9544
  • Fax: 256-829-9522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateAL

VIII. Authorized Official

Name: MRS. MELINDA KAY HANSON
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 256-829-9544