Provider Demographics
NPI:1740680941
Name:INDUSTRIAL PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:INDUSTRIAL PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERAL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SERAFINI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:256-490-7749
Mailing Address - Street 1:3880 HOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHSIDE
Mailing Address - State:AL
Mailing Address - Zip Code:35907-7077
Mailing Address - Country:US
Mailing Address - Phone:256-490-7749
Mailing Address - Fax:
Practice Address - Street 1:922 E MEIGHAN BLVD
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1922
Practice Address - Country:US
Practice Address - Phone:256-549-2688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1385261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12176717OtherCAQH
AL051538404Medicare UPIN