Provider Demographics
NPI:1649054818
Name:VULCAN PERFORMANCE INVERNESS, LLC
Entity type:Organization
Organization Name:VULCAN PERFORMANCE INVERNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:205-761-1068
Mailing Address - Street 1:3918 MONTCLAIR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2417
Mailing Address - Country:US
Mailing Address - Phone:205-761-1068
Mailing Address - Fax:205-719-4158
Practice Address - Street 1:157 RESOURCE CENTER PKWY STE 107
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8135
Practice Address - Country:US
Practice Address - Phone:205-761-1068
Practice Address - Fax:205-719-4158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VULCAN PERFORMANCE REHABILITATION AND RECOVERY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty