Organization Name: | ONMARK PHYSICAL THERAPY, LLC |
NPI Number: | 1689930513 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KILEY RUSSELL (PAYOR RELATIONS COORDINATOR) |
Mailing Address: | 2345 Moody Pkwy Ste 206 Moody |
State: | AL US |
Postal Code: | 350043039 |
Phone Number: | 2056404881 |
Fax Number: | 2056404882 |
NPI Enumeration Date: | 04/04/2012 |
NPI Last Update Date: | 04/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |