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General NPI Number Information
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NPI Number | 1073777223
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Entity Type | Organization
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Legal Business Name | MILLENNIUM PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 4847 PROMENADE PKWY STE 102
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City | BESSEMER
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State | AL
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Zip | 35022-7310
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Country | US
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Telephone | 205-481-9012
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Fax | 205-481-9014
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Provider Business Mailing Address
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Address Line | 4863 PROMENADE PKWY SUITE 109
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City | BESSEMER
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State | AL
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Zip | 35022-7305
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Country | US
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Telephone | 205-481-9012
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Fax | 205-481-9014
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Authorized Official
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Title or Position | OWNER
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Name | MR. JON MICHAEL LAMB
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Credential | MS, PT
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Telephone | 205-365-7602
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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 | PTH3086
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License Number State | AL
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