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General NPI Number Information
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NPI Number | 1003000498
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Entity Type | Organization
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Legal Business Name | BURDINE PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 311 LONGWOOD DR, SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-2728
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Country | US
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Telephone | 256-534-5946
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Fax | 256-534-3041
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Provider Business Mailing Address
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Address Line | P.O. BOX 1026
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City | HUNTSVILLE
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State | AL
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Zip | 35807-2728
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Country | US
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Telephone | 256-534-5946
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Fax | 256-534-3041
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DOROTHY I BURDINE
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Credential | PT
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Telephone | 256-534-5946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PTH2024
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License Number State | AL
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