Provider Demographics
NPI:1902207236
Name:THE CENTER FOR BALANCE AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR BALANCE AND REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:DEKLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:205-259-3991
Mailing Address - Street 1:354 W DELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1723
Mailing Address - Country:US
Mailing Address - Phone:205-259-3991
Mailing Address - Fax:
Practice Address - Street 1:354 W DELWOOD DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1723
Practice Address - Country:US
Practice Address - Phone:205-259-3991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH2117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty