Provider Demographics
NPI:1275753188
Name:RELIFORD, ANDREA LENISE (PT, ATC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LENISE
Last Name:RELIFORD
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 DUBLIN CT SO
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35212-1936
Mailing Address - Country:US
Mailing Address - Phone:205-903-9205
Mailing Address - Fax:
Practice Address - Street 1:5511 HIGHWAY 280 EAST
Practice Address - Street 2:SUITE 105
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2833
Practice Address - Country:US
Practice Address - Phone:205-408-0700
Practice Address - Fax:205-408-0702
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52552251X0800X
AL8052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer