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General NPI Number Information
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NPI Number | 1881820603
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Entity Type | Organization
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Legal Business Name | KALE DEMENT PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 410 JOHNSTON ST SE SUITE C
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City | DECATUR
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State | AL
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Zip | 35601-3069
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Country | US
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Telephone | 256-345-0519
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1684
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City | DECATUR
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State | AL
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Zip | 35602-1684
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KALE DEMENT
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Credential |
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Telephone | 256-345-0519
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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 | 29648
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License Number State | AL
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