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General NPI Number Information
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NPI Number | 1821339060
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Entity Type | Organization
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Legal Business Name | SOUTHERN CARE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 230 HUGHES RD STE F
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City | MADISON
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State | AL
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Zip | 35758-1113
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Country | US
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Telephone | 256-682-0616
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Fax |
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Provider Business Mailing Address
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Address Line | 230 HUGHES RD STE F
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City | MADISON
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State | AL
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Zip | 35758-1113
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Country | US
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Telephone | 256-682-0616
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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. TAMMY PRIDGEN WALTERS
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Credential | PT
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Telephone | 256-682-0616
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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 |
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License Number State |
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