Healthcare Provider Details

I. General information

NPI: 1518065994
Provider Name (Legal Business Name): PAIN AND REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 VALLEYDALE RD STE 100
HOOVER AL
35244-2100
US

IV. Provider business mailing address

2270 VALLEYDALE RD STE 100
HOOVER AL
35244-2086
US

V. Phone/Fax

Practice location:
  • Phone: 205-591-7246
  • Fax: 205-591-4420
Mailing address:
  • Phone: 205-982-3596
  • Fax: 205-982-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL MICHAEL DOLEYS
Title or Position: OWNER/DIRECTOR
Credential: PH.D.
Phone: 205-591-7246