=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710892765
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH ROSE BYRD DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2026
-----------------------------------------------------
Last Update Date | 08/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2500 3RD AVE S
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35233-2517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-202-6078
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 WILLOW LAKE LN
-----------------------------------------------------
City | WILSONVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35186-5407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-383-2986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PTH12797
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------