Provider Demographics
NPI:1386851061
Name:PLAINSMAN PARK PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PLAINSMAN PARK PHYSICAL THERAPY
Other - Org Name:AUBURN UNVERSITY ATHLETIC DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER OF PHYSCIAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:334-844-9919
Mailing Address - Street 1:349 S DONAHUE DR
Mailing Address - Street 2:PLAINSMAN PARK PHYSICAL THERAPY
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36849-0001
Mailing Address - Country:US
Mailing Address - Phone:334-844-9919
Mailing Address - Fax:334-844-8139
Practice Address - Street 1:349 S DONAHUE DR
Practice Address - Street 2:PLAINSMAN PARK PHYSICAL THERAPY
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36849-0001
Practice Address - Country:US
Practice Address - Phone:334-844-9919
Practice Address - Fax:334-844-8139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUBURN UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy