Provider Demographics
NPI:1346741139
Name:WARE, LINDA T (RPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:T
Last Name:WARE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARK PL
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-7743
Mailing Address - Country:US
Mailing Address - Phone:334-872-3471
Mailing Address - Fax:334-872-8923
Practice Address - Street 1:100 PARK PL
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-7743
Practice Address - Country:US
Practice Address - Phone:334-872-3471
Practice Address - Fax:334-872-8923
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist