Provider Demographics
NPI:1750703286
Name:SPINE AND REHAB SOLUTIONS, LLC
Entity type:Organization
Organization Name:SPINE AND REHAB SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:251-301-7066
Mailing Address - Street 1:820 S UNIVERSITY BLVD
Mailing Address - Street 2:STE 1A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-7858
Mailing Address - Country:US
Mailing Address - Phone:251-301-7066
Mailing Address - Fax:251-301-7058
Practice Address - Street 1:820 S UNIVERSITY BLVD
Practice Address - Street 2:STE 1A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-7858
Practice Address - Country:US
Practice Address - Phone:251-301-7066
Practice Address - Fax:251-301-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51008986OtherBLUE CROSS
ALS80301Medicare UPIN