# ALLEGRA WELLNESS OF TUSCALOOSA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205515848
- **Authorized official:** MICHELLE HAWTHORNE (BILLING MANAGER)
- **Authorized official phone:** (205) 292-2428

## Contact information

- **Practice address:** 4804 HIGHWAY 69 N, NORTHPORT, AL 35473-2035
- **Practice address phone:** (205) 556-5634
- **Mailing address:** PO BOX 440, COTTONDALE, AL 35453-0105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2023
- **Last updated:** 07/12/2023