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General NPI Number Information
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NPI Number | 1063735223
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Entity Type | Organization
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Legal Business Name | EW MOTION THERAPY TRUSSVILLE LLC
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 183 MAIN ST STE D
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City | TRUSSVILLE
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State | AL
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Zip | 35173-1495
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Country | US
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Telephone | 205-655-1009
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Fax | 205-655-1264
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Provider Business Mailing Address
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Address Line | 4 OFFICE PARK CIR STE 217
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City | MOUNTAIN BRK
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State | AL
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Zip | 35223-2674
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Country | US
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Telephone | 205-263-2770
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Fax | 205-263-0994
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | RACHEL GOLDEN
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Credential |
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Telephone | 205-263-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | AL
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