Healthcare Provider Details

I. General information

NPI: 1043346380
Provider Name (Legal Business Name): ENCORE REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5643 SERMON RD S
THEODORE AL
36582-3608
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 251-660-1505
  • Fax: 251-660-9007
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 G HENDERSON
Title or Position: PRESIDENT
Credential: PT
Phone: 256-350-1764