| NPI | 1508879883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR DALE RUSSELL President 256-325-3280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH2852) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH3369) |
| 225100000X Physical Therapist (Licence: AL PTH255) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2010-06-08 |