=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023963238
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VIRGINIA MICHAELS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2506B DANVILLE RD SW STE 200
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35603-4213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-350-6331
-----------------------------------------------------
Fax | 256-350-1990
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 42465 HIGHWAY 195
-----------------------------------------------------
City | HALEYVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35565-7052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-350-1764
-----------------------------------------------------
Fax | 256-355-0884
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PTH12607
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------