Provider Demographics
NPI:1740940030
Name:PAUL, DYLAN (PT)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:
Last Name:PAUL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9041 EAGLE VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6994
Mailing Address - Country:US
Mailing Address - Phone:732-822-6934
Mailing Address - Fax:
Practice Address - Street 1:1801 GADSDEN HWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3134
Practice Address - Country:US
Practice Address - Phone:205-228-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030437225100000X
ALPTH10640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist