# SOUTHERN SPINE AND SPORT

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

## Provider details

- **NPI number:** 1235907338
- **Authorized official:** RUSSELL SALMON DPT (OWNER)
- **Authorized official phone:** (850) 860-0884

## Contact information

- **Practice address:** 2200 OZARK HWY, ENTERPRISE, AL 36330-8231
- **Practice address phone:** (850) 860-0884
- **Mailing address:** 2200 OZARK HWY, ENTERPRISE, AL 36330-8231
- **Mailing address phone:** (850) 860-0884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/18/2023
- **Last updated:** 12/18/2023