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General NPI Number Information
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NPI Number | 1174093652
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Entity Type | Organization
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Legal Business Name | DRAYER PHYSICAL THERAPY-ALABAMA, LLC
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 1215 CHESNUT BYP STE B
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City | CENTRE
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State | AL
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Zip | 35960-2830
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Country | US
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Telephone | 256-266-1001
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Fax | 256-266-1071
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Provider Business Mailing Address
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Address Line | 199 N BROOKMOORE DR
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City | COLUMBUS
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State | MS
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Zip | 39705-2024
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Country | US
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Telephone | 662-327-6705
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Fax | 662-327-6760
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Authorized Official
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Title or Position | MANAAGER OF PROV & PAYOR ENROLLMENT
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Name | PAMELA GARDNER
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Credential |
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Telephone | 717-839-2156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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