Provider Demographics
NPI:1417923137
Name:NETTLES, JAMES E (RPT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:NETTLES
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6767 OLD MADISON PIKE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2172
Mailing Address - Country:US
Mailing Address - Phone:256-922-6650
Mailing Address - Fax:256-922-6651
Practice Address - Street 1:6767 OLD MADISON PIKE
Practice Address - Street 2:SUITE 400
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2172
Practice Address - Country:US
Practice Address - Phone:256-922-6650
Practice Address - Fax:256-922-6651
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51528524OtherBCBS