Provider Demographics
NPI:1972658565
Name:CAVIN, JODI (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:CAVIN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 INDEPENDENCE DR.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4111
Mailing Address - Country:US
Mailing Address - Phone:205-803-2210
Mailing Address - Fax:205-803-2214
Practice Address - Street 1:3105 INDEPENDENCE DR.
Practice Address - Street 2:SUITE 105
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4111
Practice Address - Country:US
Practice Address - Phone:205-803-2210
Practice Address - Fax:205-803-2214
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-38534OtherBLUE CROSS BLUE SHIELD
AL515-38534OtherPHYSICAL THERAPIST
AL016587Medicare UPIN