Provider Demographics
NPI:1588627343
Name:SERENA, WILLIAM WAYNE JR (PT, MSPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WAYNE
Last Name:SERENA
Suffix:JR
Gender:M
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7270 GADSDEN HWY # 104-108
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-2640
Mailing Address - Country:US
Mailing Address - Phone:659-444-1193
Mailing Address - Fax:205-895-6639
Practice Address - Street 1:7270 GADSDEN HWY # 104-108
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-2640
Practice Address - Country:US
Practice Address - Phone:659-444-1193
Practice Address - Fax:205-895-6639
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013951L225100000X
ALPTH8403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist