Healthcare Provider Details

I. General information

NPI: 1447821194
Provider Name (Legal Business Name): SUMMIT PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2021
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 BRYAN RD STE 360
SUMITON AL
35148-3436
US

IV. Provider business mailing address

8059 MITCHELL LN
VESTAVIA HILLS AL
35216-6821
US

V. Phone/Fax

Practice location:
  • Phone: 205-607-0632
  • Fax:
Mailing address:
  • Phone: 205-531-4200
  • 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: MICHELLE E SMITH
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 205-531-4200