Provider Demographics
NPI:1780111344
Name:FYZICAL THERAPY OF TUSCALOOSA LLC
Entity type:Organization
Organization Name:FYZICAL THERAPY OF TUSCALOOSA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:THWEATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-758-9041
Mailing Address - Street 1:1300 MCFARLAND BLVD NE STE 150
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2283
Mailing Address - Country:US
Mailing Address - Phone:205-758-9041
Mailing Address - Fax:205-345-8328
Practice Address - Street 1:1300 MCFARLAND BLVD NE STE 150
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2283
Practice Address - Country:US
Practice Address - Phone:205-758-9041
Practice Address - Fax:205-345-8328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty