Provider Demographics
NPI:1417196221
Name:TRINITY PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:TRINITY PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AUSIE
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:BEAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:404-944-3991
Mailing Address - Street 1:7402 HIGHWAY 69 S STE G
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-1301
Mailing Address - Country:US
Mailing Address - Phone:205-758-5832
Mailing Address - Fax:205-758-5834
Practice Address - Street 1:7402 HIGHWAY 69 S STE G
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-1301
Practice Address - Country:US
Practice Address - Phone:205-758-5832
Practice Address - Fax:205-758-5834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1801975628225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty