Provider Demographics
NPI:1376282590
Name:GADSDEN PELVIC REHAB LLC
Entity Type:Organization
Organization Name:GADSDEN PELVIC REHAB LLC
Other - Org Name:GADSDEN PELVIC REHAB AND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, DPT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JAZMA
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-689-5129
Mailing Address - Street 1:500 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5104
Mailing Address - Country:US
Mailing Address - Phone:256-212-0032
Mailing Address - Fax:
Practice Address - Street 1:500 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5104
Practice Address - Country:US
Practice Address - Phone:256-212-0032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-04
Last Update Date:2023-07-04
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
256-212-0032OtherPHONE