| Organization Name: | CHAMPION SPORTS MEDICINE |
| NPI Number: | 1588063986 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AARON JOSEPH POIRIER (PHYSICAL THERAPIST) |
| Mailing Address: | 3014 Allison Bonnett Memorial Dr Ste 144 Hueytown |
| State: | AL US |
| Postal Code: | 350232394 |
| Phone Number: | 2057449444 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2014 |
| NPI Last Update Date: | 08/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PTH7300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |