Provider Demographics
NPI:1881914109
Name:PRESSLEY, BETHANY MARIE (PTA)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MARIE
Last Name:PRESSLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 INDEPENDENCE DR
Mailing Address - Street 2:300B
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4159
Mailing Address - Country:US
Mailing Address - Phone:205-879-7501
Mailing Address - Fax:205-879-0675
Practice Address - Street 1:3125 INDEPENDENCE DR
Practice Address - Street 2:300B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4159
Practice Address - Country:US
Practice Address - Phone:205-879-7501
Practice Address - Fax:205-879-0675
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2617225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-07722OtherBLUE CROSS BLUE SHIELD OF ALABAMA
ALPTA5871OtherSTATE LICENSE NO
AL2617OtherTEMPORARY STATE LICENSE