Provider Demographics
NPI:1639768666
Name:MIMS, JARED (DPT)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:MIMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 10TH AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1248
Mailing Address - Country:US
Mailing Address - Phone:205-933-7838
Mailing Address - Fax:
Practice Address - Street 1:210 FIELDSTOWN RD STE 108
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2418
Practice Address - Country:US
Practice Address - Phone:205-285-2180
Practice Address - Fax:205-285-2181
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist