Healthcare Provider Details

I. General information

NPI: 1548509367
Provider Name (Legal Business Name): CHRISTINE MILES ESPY PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4941 MONTEVALLO RD
IRONDALE AL
35210-2418
US

IV. Provider business mailing address

4941 MONTEVALLO RD
IRONDALE AL
35210-2418
US

V. Phone/Fax

Practice location:
  • Phone: 205-314-4266
  • Fax: 205-951-6773
Mailing address:
  • Phone: 205-314-4266
  • Fax: 205-951-6773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH3016
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPTH3016
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: