| Organization Name: | IMPACT REHABILITATION AND SPORTS MEDICINE, INC. |
| NPI Number: | 1497861926 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL CHADWICK (OWNER) |
| Mailing Address: | 101 Carrington Ln Ste C Calera |
| State: | AL US |
| Postal Code: | 350405439 |
| Phone Number: | 2056213077 |
| Fax Number: | 2056213788 |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 04/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |