Healthcare Provider Details

I. General information

NPI: 1902522055
Provider Name (Legal Business Name): ENCORE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 TALLAPOOSA ST STE 1
WADLEY AL
36276-4215
US

IV. Provider business mailing address

251 JOHNSTON ST SE STE 200
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 334-745-0396
  • Fax: 334-833-1225
Mailing address:
  • Phone: 256-350-1764
  • Fax: 256-355-0884

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 HENDERSON
Title or Position: PRESIDENT
Credential:
Phone: 256-350-1764