Healthcare Provider Details

I. General information

NPI: 1770830242
Provider Name (Legal Business Name): ENCORE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 MCFARLAND BLVD
NORTHPORT AL
35476-3348
US

IV. Provider business mailing address

251 JOHNSTON ST SE SUITE 300
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 205-344-9161
  • Fax: 205-344-9256
Mailing address:
  • Phone: 256-340-9708
  • Fax: 256-340-9624

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: PAUL HENDERSON
Title or Position: PRESIDENT
Credential: PT
Phone: 256-350-1764