Provider Demographics
NPI:1083334205
Name:WADDELL, JOSIE (DPT)
Entity Type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:WADDELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OFFICE PARK CIR STE 217
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2674
Mailing Address - Country:US
Mailing Address - Phone:205-263-2770
Mailing Address - Fax:205-263-0994
Practice Address - Street 1:10 MEADOWVIEW DR STE 201
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-7700
Practice Address - Country:US
Practice Address - Phone:205-332-3000
Practice Address - Fax:205-545-8358
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist