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General NPI Number Information
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NPI Number | 1750703286
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Entity Type | Organization
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Legal Business Name | SPINE AND REHAB SOLUTIONS, LLC
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 820 S UNIVERSITY BLVD STE 1A
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City | MOBILE
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State | AL
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Zip | 36609-7858
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Country | US
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Telephone | 251-301-7066
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Fax | 251-301-7058
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Provider Business Mailing Address
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Address Line | 820 S UNIVERSITY BLVD STE 1A
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City | MOBILE
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State | AL
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Zip | 36609-7858
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Country | US
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Telephone | 251-301-7066
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Fax | 251-301-7058
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SHARON YOUNG
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Credential | PT
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Telephone | 251-301-7066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH1107
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License Number State | AL
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