Provider Demographics
NPI:1730286964
Name:THERAPY SOUTH PELHAM, LLC
Entity Type:Organization
Organization Name:THERAPY SOUTH PELHAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:205-664-8404
Mailing Address - Street 1:2823 GREYSTONE COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2660
Mailing Address - Country:US
Mailing Address - Phone:205-745-3660
Mailing Address - Fax:205-745-3649
Practice Address - Street 1:3569 PELHAM PKWY STE 7
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124
Practice Address - Country:US
Practice Address - Phone:205-664-8404
Practice Address - Fax:205-664-8559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty