Healthcare Provider Details

I. General information

NPI: 1902836745
Provider Name (Legal Business Name): PHYSICAL THERAPY OF PHENIX CITY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 9TH AVE
PHENIX CITY AL
36867-5027
US

IV. Provider business mailing address

6270A N UCHEE RD
HATCHECHUBBEE AL
36858-2808
US

V. Phone/Fax

Practice location:
  • Phone: 334-448-2641
  • Fax: 334-298-6086
Mailing address:
  • Phone: 334-448-3900
  • Fax: 334-298-6086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number17304
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPTH3832
License Number StateAL

VIII. Authorized Official

Name: DR. MARIA FE GODBEY
Title or Position: CEO, PHYSICAL THERAPIST
Credential: PT, DPT, NCS
Phone: 334-448-3900