Provider Demographics
NPI:1801411624
Name:GODSPEED ESA HUNTSVILLE LLC
Entity Type:Organization
Organization Name:GODSPEED ESA HUNTSVILLE LLC
Other - Org Name:GODSPEED JONES VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:256-230-7709
Mailing Address - Street 1:7242 BAILEY COVE RD SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2746
Mailing Address - Country:US
Mailing Address - Phone:205-292-2428
Mailing Address - Fax:
Practice Address - Street 1:7242 BAILEY COVE RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2746
Practice Address - Country:US
Practice Address - Phone:205-292-2428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy