Provider Demographics
NPI:1386831006
Name:PHYSICAL THERAPY CENTER OF NORTH ALABAMA
Entity Type:Organization
Organization Name:PHYSICAL THERAPY CENTER OF NORTH ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:LOCKRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-517-5091
Mailing Address - Street 1:204 LOWE AVE SE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4242
Mailing Address - Country:US
Mailing Address - Phone:256-517-5091
Mailing Address - Fax:256-517-5092
Practice Address - Street 1:204 LOWE AVE SE
Practice Address - Street 2:SUITE 7
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4242
Practice Address - Country:US
Practice Address - Phone:256-517-5091
Practice Address - Fax:256-517-5092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL64899261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy