# UNIVERSITY OF SOUTH ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** USA Pediatric Therapy - Occupational Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205303153
- **Authorized official:** GLEN OWEN BAILEY (CEO)
- **Authorized official phone:** (251) 471-7118

## Contact information

- **Practice address:** 1610 CENTER ST STE B, MOBILE, AL 36604-1512
- **Practice address phone:** (251) 415-1670
- **Mailing address:** PO BOX 40480, MOBILE, AL 36640-0480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/30/2018
- **Last updated:** 10/30/2018