Healthcare Provider Details

I. General information

NPI: 1316113087
Provider Name (Legal Business Name): ENCORE REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HIGHWAY 43, OFFICE # 4 TRAUMA ROOM
MCINTOSH AL
36553
US

IV. Provider business mailing address

1908 FLINT RD SE
DECATUR AL
35601-6031
US

V. Phone/Fax

Practice location:
  • Phone: 251-944-0611
  • Fax: 251-944-2132
Mailing address:
  • Phone: 256-340-9708
  • Fax: 256-340-9624

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 G HENDERSON
Title or Position: PRESIDENT
Credential: PT
Phone: 256-350-1764