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General NPI Number Information
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NPI Number | 1437079415
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Entity Type | Organization
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Legal Business Name | REFINE PT AND PERFORMANCE - FAIRHOPE LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 22806A US HIGHWAY 98
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City | FAIRHOPE
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State | AL
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Zip | 36532-3328
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Country | US
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Telephone | 251-501-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 108 S FLORIDA ST
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City | MOBILE
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State | AL
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Zip | 36606-1927
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KYLE THIBODEAUX
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Credential | PT, DPT, OCS, CSCS
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Telephone | 251-501-2700
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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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