Provider Demographics
NPI:1326133463
Name:A.C.T. PHYSICAL THERAPY. LLC
Entity Type:Organization
Organization Name:A.C.T. PHYSICAL THERAPY. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-824-8850
Mailing Address - Street 1:PO BOX 661495
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35266-1495
Mailing Address - Country:US
Mailing Address - Phone:205-979-5882
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:1310 ALFORD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3199
Practice Address - Country:US
Practice Address - Phone:205-824-8850
Practice Address - Fax:205-824-8853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529927480Medicaid
ALDF0049OtherRAILROAD MEDICARE GROUP #
AL529927480Medicaid