Healthcare Provider Details

I. General information

NPI: 1053822312
Provider Name (Legal Business Name): VULCAN PERFORMANCE REHABILITATION AND RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3918 MONTCLAIR RD STE 101
MOUNTAIN BRK AL
35213-2417
US

IV. Provider business mailing address

3918 MONTCLAIR RD STE 101
MOUNTAIN BRK AL
35213-2417
US

V. Phone/Fax

Practice location:
  • Phone: 205-471-4438
  • Fax:
Mailing address:
  • Phone: 205-761-1068
  • Fax: 205-719-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH8536
License Number StateAL

VIII. Authorized Official

Name: DR. SEAN ALLEN HILLER
Title or Position: OWNER, DOCTOR OF PHYSICAL THERAPY
Credential: PT, DPT, CSCS
Phone: 205-471-4438