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Individual

MASON MCANNALLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
183 MAIN ST STE D, TRUSSVILLE, AL 35173-1496
(205) 655-1009
(205) 655-1264
Mailing address
4 OFFICE PARK CIR STE 217, MOUNTAIN BRK, AL 35223-2674
(205) 263-2770
(205) 263-0994

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH9547
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTH9547
LICENSE
AL
Enumeration date
08/20/2019
Last updated
10/18/2021
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