# TBD

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

## Provider details

- **NPI number:** 1972981918
- **Authorized official:** BRET STACY PT (PHYSICAL THERAPIST)
- **Authorized official phone:** (205) 259-3991

## Contact information

- **Practice address:** 76359 AL HIGHWAY 77, LINCOLN, AL 35096-5039
- **Practice address phone:** (205) 259-3991
- **Practice address fax:** (205) 683-2468
- **Mailing address:** 76359 AL HIGHWAY 77, LINCOLN, AL 35096
- **Mailing address phone:** (205) 259-3991
- **Mailing address fax:** (205) 683-2468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PTH7544 | AL | Yes |

## Other

- **Enumeration date:** 05/11/2015
- **Last updated:** 10/26/2015