Provider Demographics
NPI:1245392984
Name:WEBB, DAVID MARK (PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:WEBB
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 1:140 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7972
Mailing Address - Country:US
Mailing Address - Phone:706-888-7195
Mailing Address - Fax:
Practice Address - Street 1:6451 MERRITT BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4827
Practice Address - Country:US
Practice Address - Phone:251-621-3866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist