Provider Demographics
NPI:1346469004
Name:REACH PEDIATRICS THERAPY SERVICES PC
Entity Type:Organization
Organization Name:REACH PEDIATRICS THERAPY SERVICES PC
Other - Org Name:ROBIN IRWIN PHYSICAL THERAPY SERVICES P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MODI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:256-289-0882
Mailing Address - Street 1:1931 CENTRAL PKWY SW
Mailing Address - Street 2:SUITE S
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-309-0454
Mailing Address - Fax:256-309-0422
Practice Address - Street 1:1931 CENTRAL PKWY SW
Practice Address - Street 2:SUITE S
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-309-0454
Practice Address - Fax:256-309-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1007261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529501390Medicaid