| Organization Name: | THERAPY SOUTH FULTONDALE |
| NPI Number: | 1972787687 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER KENNEDY (GROUP BUSINESS MANAGER) |
| Mailing Address: | 3471 Lowery Parkway Suite 107 Fultondale |
| State: | AL US |
| Postal Code: | 35068 |
| Phone Number: | 2058496566 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2007 |
| NPI Last Update Date: | 12/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PTH3497 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |