| Organization Name: | IMPACT THERAPY, INC |
| NPI Number: | 1073916292 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY KNOWLES (OWNER) |
| Mailing Address: | 235 Pope Rd Gadsden |
| State: | AL US |
| Postal Code: | 359018398 |
| Phone Number: | 2055593688 |
| Fax Number: | |
| NPI Enumeration Date: | 10/01/2014 |
| NPI Last Update Date: | 10/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PTH4018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |