Provider Demographics
NPI:1265456131
Name:SPRAYBERRY, JOE NEAL (PT)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:NEAL
Last Name:SPRAYBERRY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:208 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3432
Practice Address - Country:US
Practice Address - Phone:251-948-2045
Practice Address - Fax:251-948-2048
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-30631OtherBCBS
ALDB9027OtherRAILROAD MEDICARE GROUP
AL1003819608OtherNPI GROUP
AL7181379OtherAETNA
AL1003819608OtherNPI GROUP