Provider Demographics
NPI:1073619227
Name:INTEGRITY SPORTS MEDICINE & REHABILITATION
Entity Type:Organization
Organization Name:INTEGRITY SPORTS MEDICINE & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:256-736-8875
Mailing Address - Street 1:1811 DAHLKE DR
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-3625
Mailing Address - Country:US
Mailing Address - Phone:256-739-1370
Mailing Address - Fax:256-739-1956
Practice Address - Street 1:1811 DAHLKE DR
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-3625
Practice Address - Country:US
Practice Address - Phone:256-739-1370
Practice Address - Fax:256-739-1956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK473Medicare ID - Type Unspecified