Provider Demographics
NPI:1265706170
Name:BISHOP PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:BISHOP PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:251-626-7778
Mailing Address - Street 1:1203 US HIGHWAY 98
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4277
Mailing Address - Country:US
Mailing Address - Phone:251-626-7778
Mailing Address - Fax:251-626-7780
Practice Address - Street 1:1203 US HIGHWAY 98
Practice Address - Street 2:SUITE 1-C
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4277
Practice Address - Country:US
Practice Address - Phone:251-626-7778
Practice Address - Fax:251-626-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL39470261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy