Provider Demographics
NPI:1841408762
Name:HUSSEY, MARC ALAN (PT)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:ALAN
Last Name:HUSSEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 INTERSTATE PARK DR STE 324
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-5468
Mailing Address - Country:US
Mailing Address - Phone:334-272-0313
Mailing Address - Fax:334-272-0448
Practice Address - Street 1:300 INTERSTATE PARK DR STE 324
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5468
Practice Address - Country:US
Practice Address - Phone:334-272-0313
Practice Address - Fax:334-272-0448
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist