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General NPI Number Information
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NPI Number | 1700123445
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Entity Type | Organization
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Legal Business Name | WEST ALABAMA THERAPY
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 3985 PARK WOOD ROAD SUITE 109 #148
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City | BESSEMER
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State | AL
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Zip | 35022
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Country | US
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Telephone | 205-901-4777
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Fax | 888-334-3477
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Provider Business Mailing Address
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Address Line | 3985 PARK WOOD ROAD SUITE 109 #148
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City | BESSEMER
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State | AL
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Zip | 35022
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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 | MRS. COURTNEY DUFF HARRISON
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Credential |
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Telephone | 205-901-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 2512
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License Number State | AL
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