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NPI Code Detail

MEDICARE: GODSPEED ESA HUNTSVILLE LLC

MEDICARE: GODSPEED ESA HUNTSVILLE LLC
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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1801411624
Entity Type Code : Organization
Provider Name (Legal Business Name) : GODSPEED ESA HUNTSVILLE LLC
Provider Business Mailing Address
First Line : 7242 BAILEY COVE RD SE
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35802-2746
Country : US
Telephone Number : 205-292-2428
Fax Number :
Provider Business Practice Location Address
First Line : 7242 BAILEY COVE RD SE
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35802-2746
Country : US
Telephone Number : 205-292-2428
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : JARED DOWLING
Credential : DPT
Telephone Number : 256-230-7709
Provider Enumeration Date : 06/09/2020
Last Update Date : 08/31/2023

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Directions to “GODSPEED ESA HUNTSVILLE LLC ” Practice Location

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