Healthcare Provider Details

I. General information

NPI: 1770893943
Provider Name (Legal Business Name): THE CENTER FOR PHYSICAL MEDICINE AND PAIN MANAGEMENT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 TAYLOR RD
MONTGOMERY AL
36117-3439
US

IV. Provider business mailing address

2227 TAYLOR RD
MONTGOMERY AL
36117-3439
US

V. Phone/Fax

Practice location:
  • Phone: 334-260-8988
  • Fax: 334-260-8225
Mailing address:
  • Phone: 334-260-8988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberDO489
License Number StateAL

VIII. Authorized Official

Name: DR. RACHELLE B JANUSH
Title or Position: MEDICAL DIRECTOR / OWNER
Credential: DO
Phone: 334-260-8988