Provider Demographics
NPI:1710179064
Name:ALABAMA PHYSICAL SERVICES
Entity Type:Organization
Organization Name:ALABAMA PHYSICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-290-0021
Mailing Address - Street 1:430 GREEN SPRINGS HWY
Mailing Address - Street 2:SUITE 21
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4945
Mailing Address - Country:US
Mailing Address - Phone:205-290-0021
Mailing Address - Fax:205-290-2187
Practice Address - Street 1:430 GREEN SPRINGS HWY
Practice Address - Street 2:SUITE 21
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4945
Practice Address - Country:US
Practice Address - Phone:205-290-0021
Practice Address - Fax:205-290-2187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service