Provider Demographics
NPI:1568952679
Name:EQUILIBRIUM PT, LLC
Entity Type:Organization
Organization Name:EQUILIBRIUM PT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PTH
Authorized Official - Phone:205-541-2252
Mailing Address - Street 1:2415 MOORES MILL RD UNIT 210
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-8482
Mailing Address - Country:US
Mailing Address - Phone:205-541-2252
Mailing Address - Fax:205-383-1251
Practice Address - Street 1:2415 MOORES MILL RD UNIT 210
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-8482
Practice Address - Country:US
Practice Address - Phone:205-541-2252
Practice Address - Fax:205-383-1251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4046208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty