Provider Demographics
NPI:1811196124
Name:MEHARRY PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:MEHARRY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MEHARRY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:205-759-5995
Mailing Address - Street 1:525 ENERGY CENTER BLVD
Mailing Address - Street 2:SUITE 1601
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5830
Mailing Address - Country:US
Mailing Address - Phone:205-759-5995
Mailing Address - Fax:205-759-5935
Practice Address - Street 1:525 ENERGY CENTER BLVD
Practice Address - Street 2:SUITE 1601
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5830
Practice Address - Country:US
Practice Address - Phone:205-759-5995
Practice Address - Fax:205-759-5935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1360261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1073690640OtherINDIVIDUAL NPI NUMBER
AL74172OtherBLUE CROSS/BLUE SHIELD
AL=========OtherEIN