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General NPI Number Information
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NPI Number | 1396780706
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Entity Type | Organization
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Legal Business Name | INNERFIT WEST, LLC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1601 FOREST AVE
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City | MONTGOMERY
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State | AL
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Zip | 36106-1541
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Country | US
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Telephone | 334-262-6878
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Fax | 334-262-6258
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Provider Business Mailing Address
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Address Line | 7088 UNIVERSITY CT
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City | MONTGOMERY
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State | AL
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Zip | 36117-6992
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Country | US
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Telephone | 334-396-1400
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Fax | 334-396-2727
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | TINA LOGAN
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Credential | RPT
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Telephone | 334-262-6878
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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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