MEDICARE: BIRMINGHAM PHYSICAL THERAPY & SPORTS MEDICINE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1154426260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIRMINGHAM PHYSICAL THERAPY & SPORTS MEDICINE INC

Provider Business Mailing Address
First Line	:	3234 CAHABA HEIGHTS RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-5243
Country	:	US
Telephone Number	:	205-298-9101
Fax Number	:	205-298-9103

Provider Business Practice Location Address
First Line	:	3234 CAHABA HEIGHTS RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-5243
Country	:	US
Telephone Number	:	205-298-9101
Fax Number	:	205-298-9103

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	ELLEN HAMILTON
Credential	:
Telephone Number	:	205-298-9101

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	10/17/2013

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