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NPI 1790411619

NPI 1790411619 : JOSHUA MCNAIRY RKT : TUSCALOOSA, AL

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General NPI Number Information
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    NPI Number           |    1790411619
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA MCNAIRY RKT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/25/2022
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    Last Update Date     |    07/25/2022
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Provider Practice Location Address
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    Address Line         |    3701 LOOP RD 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35404-5015
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    Country              |    US
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    Telephone            |    205-554-2000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3701 LOOP RD 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35404-5015
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    Country              |    US
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    Telephone            |    205-554-2000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    226300000X
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    Taxonomy Name        |    Kinesiotherapist
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    License Number       |    2110
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    License Number State |    MS
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