Provider Demographics
NPI:1821250473
Name:FASSHAUER THERAPY SERVICES INC
Entity Type:Organization
Organization Name:FASSHAUER THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FASSHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:205-879-9009
Mailing Address - Street 1:1900 28TH AVE S
Mailing Address - Street 2:105
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2687
Mailing Address - Country:US
Mailing Address - Phone:205-879-9009
Mailing Address - Fax:205-879-4893
Practice Address - Street 1:1900 28TH AVE S
Practice Address - Street 2:105
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2687
Practice Address - Country:US
Practice Address - Phone:205-879-9009
Practice Address - Fax:205-879-4893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1575225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ39974Medicare UPIN