Organization
AGESAFE INNOVATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CEDRIC KENNARD DONALDSON DPT (OWNER)
(601) 918-6980
Entity
Organization
Contact information
Practice address
3517 LORNA RD, SUITE 239, BIRMINGHAM, AL 35216-0906
(205) 800-4923
(205) 278-6941
Mailing address
4040 BENT RIVER LN, BIRMINGHAM, AL 35216-6802
(601) 918-6980
(205) 278-6941
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTH6362
AL
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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