Provider Demographics
NPI:1902836745
Name:PHYSICAL THERAPY OF PHENIX CITY, PC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY OF PHENIX CITY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA FE
Authorized Official - Middle Name:
Authorized Official - Last Name:GODBEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, NCS
Authorized Official - Phone:334-448-3900
Mailing Address - Street 1:6270A N UCHEE RD
Mailing Address - Street 2:
Mailing Address - City:HATCHECHUBBEE
Mailing Address - State:AL
Mailing Address - Zip Code:36858-2808
Mailing Address - Country:US
Mailing Address - Phone:334-448-3900
Mailing Address - Fax:334-298-6086
Practice Address - Street 1:1321 9TH AVE
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-5027
Practice Address - Country:US
Practice Address - Phone:334-448-2641
Practice Address - Fax:334-298-6086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL173042251E1300X
ALPTH38322251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Multi-Specialty