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General NPI Number Information
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NPI Number | 1407547839
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Entity Type | Organization
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Legal Business Name | PARK PLACE HEALTHCARE LLC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 2868 ACTON RD
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City | VESTAVIA
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State | AL
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Zip | 35243-2502
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Country | US
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Telephone | 205-900-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 2868 ACTON RD
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City | VESTAVIA
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State | AL
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Zip | 35243-2502
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Country | US
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Telephone | 205-332-3160
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Fax | 866-702-0880
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Authorized Official
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Title or Position | DIRECTOR RCM
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Name | JENA BRYANT
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Credential |
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Telephone | 205-577-6265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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