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General NPI Number Information
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NPI Number | 1386434520
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Entity Type | Individual
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Provider Name | NATHAN EAST PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/10/2025
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Last Update Date | 05/10/2025
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Provider Practice Location Address
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Address Line | 8011 LIBERTY PKWY
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City | VESTAVIA
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State | AL
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Zip | 35242-7669
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Country | US
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Telephone | 760-500-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 2308 RUSSET MEADOWS TER
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City | BIRMINGHAM
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State | AL
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Zip | 35244-4632
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Country | US
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Telephone | 205-936-9391
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH12264
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License Number State | AL
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