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General NPI Number Information
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NPI Number | 1801065537
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY OF ANDALUSIA
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 1105 W BYPASS
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City | ANDALUSIA
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State | AL
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Zip | 36420-5255
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Country | US
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Telephone | 334-222-5785
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Fax | 334-222-0181
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Provider Business Mailing Address
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Address Line | 1105 W BYPASS
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City | ANDALUSIA
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State | AL
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Zip | 36420-5255
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Country | US
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Telephone | 334-222-5785
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Fax | 334-222-8062
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. THOMAS G RIDER
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Credential | P.T.
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Telephone | 334-222-5785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PTH551
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License Number State | AL
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