Provider Demographics
NPI:1922186634
Name:NOLAN, RON DEAN (PT)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:DEAN
Last Name:NOLAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 5TH AVE.
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:AL
Mailing Address - Zip Code:36907
Mailing Address - Country:US
Mailing Address - Phone:205-392-4953
Mailing Address - Fax:205-392-4953
Practice Address - Street 1:245 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2216
Practice Address - Country:US
Practice Address - Phone:205-924-6820
Practice Address - Fax:205-942-5627
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist