Healthcare Provider Details

I. General information

NPI: 1780733329
Provider Name (Legal Business Name): BODALIA REHAB SVCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18601 E SILVERHILL RD B
ROBERTSDALE AL
36567
US

IV. Provider business mailing address

2457 AIRPORT THRUWAY 315
COLUMBUS GA
31904
US

V. Phone/Fax

Practice location:
  • Phone: 251-947-7911
  • Fax: 251-947-2697
Mailing address:
  • Phone: 706-507-5307
  • Fax: 706-507-5311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NIKETA BUDALIA
Title or Position: CLINICAL DIRECTOR
Credential: MPT
Phone: 706-507-5307