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General NPI Number Information
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NPI Number | 1609321165
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Entity Type | Organization
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Legal Business Name | OAK MOUNTAIN GROUP SERVICES, LLC
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 3070 HEALTHY WAY
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City | VESTAVIA HILLS
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State | AL
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Zip | 35243
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Country | US
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Telephone | 205-977-7216
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Fax |
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Provider Business Mailing Address
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Address Line | 5665 NEW NORTHSIDE DR SUITE 320
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City | ATLANTA
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State | GA
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Zip | 30328-5831
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Country | US
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Telephone | 770-874-5400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHRISTOPHER BRIAN DURHAM
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Credential |
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Telephone | 770-874-5400
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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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