Provider Demographics
NPI:1942243217
Name:NORTH DOTHAN PHYSICAL THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:NORTH DOTHAN PHYSICAL THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARISTOTLE
Authorized Official - Middle Name:O
Authorized Official - Last Name:KIRKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-792-2345
Mailing Address - Street 1:PO BOX 5613
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-5613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1970 REEVES ST
Practice Address - Street 2:SUITE 223
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-5882
Practice Address - Country:US
Practice Address - Phone:334-792-2345
Practice Address - Fax:334-792-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 4029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty