Healthcare Provider Details

I. General information

NPI: 1992002356
Provider Name (Legal Business Name): MOBILE PHYSICAL MEDICINE & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3929 AIRPORT BLVD BUILDING 2, SUITE 100
MOBILE AL
36609-1987
US

IV. Provider business mailing address

3929 AIRPORT BLVD BUILDING 2, SUITE 100
MOBILE AL
36609-1987
US

V. Phone/Fax

Practice location:
  • Phone: 251-450-8044
  • Fax: 251-272-8913
Mailing address:
  • Phone: 251-450-8044
  • Fax: 251-272-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number20439
License Number StateAL

VIII. Authorized Official

Name: MR. EDWARD MARTIN SCHNITZER
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 251-450-8044