Organization
THERAPY SOUTH SOHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH KELLY (CREDENTIALING SPECIALIST)
(205) 745-3660
Entity
Organization
Contact information
Practice address
2610 19TH ST S, HOMEWOOD, AL 35209-1914
(205) 558-6400
(205) 558-6405
Mailing address
2823 GREYSTONE COMMERCIAL BLVD, BIRMINGHAM, AL 35242-2660
(205) 745-3660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055586400
PHONE NUMBER
AL
Enumeration date
10/07/2019
Last updated
10/07/2019
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