Healthcare Provider Details

I. General information

NPI: 1063627909
Provider Name (Legal Business Name): MOBILE SPINE AND REHABILITATION LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 AIRPORT BLVD SUITE A 1
MOBILE AL
36608-3167
US

IV. Provider business mailing address

6051 AIRPORT BLVD SUITE A-1
MOBILE AL
36608-3167
US

V. Phone/Fax

Practice location:
  • Phone: 251-460-0201
  • Fax: 251-460-2848
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JANNA KING
Title or Position: VP, AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000