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General NPI Number Information
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NPI Number | 1205966967
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Entity Type | Individual
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Provider Name | ALLEN PERNELL RILEY OT
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 3701 LOOP RD
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5015
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Country | US
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Telephone | 205-554-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 278 ROBERT JEMISON RD APT 1A
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3657
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Country | US
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Telephone | 205-554-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | MS
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