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General NPI Number Information
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NPI Number | 1902389232
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Entity Type | Organization
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Legal Business Name | ORTHOSPORTS ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 7201 HAPPY HOLLOW RD
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City | TRUSSVILLE
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State | AL
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Zip | 35173-2458
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Country | US
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Telephone | 205-838-3090
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Fax |
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Provider Business Mailing Address
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Address Line | 833 ST. VINCENT'S DRIVE, BLDG 3, STE 403
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City | BIRMINGHAM
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State | AL
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Zip | 35205
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Country | US
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Telephone | 205-939-0447
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Fax | 205-939-0418
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORI W SILLS
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Credential |
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Telephone | 205-939-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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