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NPI Code Detail

MEDICARE: ANDALUSIA THERAPY GROUP, LLC

MEDICARE: ANDALUSIA THERAPY GROUP, 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1891542833
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDALUSIA THERAPY GROUP, LLC
Provider Business Mailing Address
First Line : 224 S THREE NOTCH ST
Second Line :
City : ANDALUSIA
State : AL
Zip : 36420-3710
Country : US
Telephone Number : 606-344-7997
Fax Number :
Provider Business Practice Location Address
First Line : 224 S THREE NOTCH ST
Second Line :
City : ANDALUSIA
State : AL
Zip : 36420-3710
Country : US
Telephone Number : 606-344-7997
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KIRBY SOLES SEWELL
Credential :
Telephone Number : 606-344-7997
Provider Enumeration Date : 05/06/2024
Last Update Date : 07/07/2024

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Directions to “ANDALUSIA THERAPY GROUP, LLC ” Practice Location

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