Healthcare Provider Details

I. General information

NPI: 1073836318
Provider Name (Legal Business Name): BRS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 DOWNTOWNER LOOP N
MOBILE AL
36609-5501
US

IV. Provider business mailing address

18601 E SILVERHILL AVE SUITE C
ROBERTSDALE AL
36567-3703
US

V. Phone/Fax

Practice location:
  • Phone: 251-747-4118
  • Fax: 877-232-9875
Mailing address:
  • Phone: 251-747-4118
  • Fax: 877-232-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. NIKETA N BODALIA
Title or Position: CEO
Credential: MSPT
Phone: 251-747-4118