Healthcare Provider Details

I. General information

NPI: 1093670572
Provider Name (Legal Business Name): PRO LEVEL PERFORMANCE & PHYSIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 OFFICE PARK CIR STE 100
MOUNTAIN BRK AL
35223-2545
US

IV. Provider business mailing address

2204 BLUE RIDGE BLVD
HOOVER AL
35226-3157
US

V. Phone/Fax

Practice location:
  • Phone: 205-527-3889
  • Fax:
Mailing address:
  • Phone: 205-527-3889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MASON MCANNALLY
Title or Position: CEO
Credential: PT, DPT
Phone: 205-527-3889