Provider Demographics
NPI:1497497028
Name:FEDERAL INJURY CENTER OF HUNTSVILLE
Entity Type:Organization
Organization Name:FEDERAL INJURY CENTER OF HUNTSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONOVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-305-1710
Mailing Address - Street 1:650 9TH AVE SW # W104
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4502
Mailing Address - Country:US
Mailing Address - Phone:205-305-1710
Mailing Address - Fax:
Practice Address - Street 1:1878 JEFF RD NW STE E
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4261
Practice Address - Country:US
Practice Address - Phone:256-945-7405
Practice Address - Fax:256-945-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy