Provider Demographics
NPI:1053822312
Name:VULCAN PERFORMANCE REHABILITATION AND RECOVERY LLC
Entity Type:Organization
Organization Name:VULCAN PERFORMANCE REHABILITATION AND RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CSCS
Authorized Official - Phone:205-471-4438
Mailing Address - Street 1:3918 MONTCLAIR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2417
Mailing Address - Country:US
Mailing Address - Phone:205-761-1068
Mailing Address - Fax:205-719-4158
Practice Address - Street 1:3918 MONTCLAIR RD STE 101
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2417
Practice Address - Country:US
Practice Address - Phone:205-471-4438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty