Healthcare Provider Details

I. General information

NPI: 1326133463
Provider Name (Legal Business Name): A.C.T. PHYSICAL THERAPY. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 ALFORD AVE SUITE 102
HOOVER AL
35226-3199
US

IV. Provider business mailing address

PO BOX 661495
BIRMINGHAM AL
35266-1495
US

V. Phone/Fax

Practice location:
  • Phone: 205-824-8850
  • Fax: 205-824-8853
Mailing address:
  • Phone: 205-979-5882
  • Fax: 205-979-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier529927480
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer
# 2
IdentifierDF0049
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerRAILROAD MEDICARE GROUP #

VIII. Authorized Official

Name: ILENE P HAYES
Title or Position: CO-OWNER
Credential:
Phone: 205-824-8850