Provider Demographics
NPI:1134821853
Name:NEBRES, PIA KARISMA (DPT)
Entity type:Individual
Prefix:
First Name:PIA KARISMA
Middle Name:
Last Name:NEBRES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BAKERS FARM DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-7517
Mailing Address - Country:US
Mailing Address - Phone:256-668-1330
Mailing Address - Fax:
Practice Address - Street 1:1218 13TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4307
Practice Address - Country:US
Practice Address - Phone:256-351-5015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist