Healthcare Provider Details

I. General information

NPI: 1558452920
Provider Name (Legal Business Name): BODALIA REHAB SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18601 E SILVERHILL AVE SUITE B
ROBERTSDALE AL
36567-3703
US

IV. Provider business mailing address

18601 E SILVERHILL AVE SUITE B
ROBERTSDALE AL
36567-3703
US

V. Phone/Fax

Practice location:
  • Phone: 251-747-4118
  • Fax: 251-947-2697
Mailing address:
  • Phone: 251-747-4118
  • Fax: 251-947-2697

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: NEHAL BODALIA
Title or Position: ADMINISTRATOR
Credential:
Phone: 251-747-4118