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NPI Code Detail

MEDICARE: GINGER BROYLES

MEDICARE:   GINGER  BROYLES
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
1225X00000XOccupational Therapist1139AL

General Provider Information

NPI Number : 1396909719
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINGER BROYLES
Provider Business Mailing Address
First Line : 2486 GURLEY PIKE
Second Line :
City : GURLEY
State : AL
Zip : 35748-9291
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 SAINT CLAIR AVE SW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-5021
Country : US
Telephone Number : 256-533-0508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2008
Last Update Date : 07/15/2008

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Directions to “ GINGER BROYLES ” Practice Location

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