Individual
CHARLES C OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3118 ROSS CLARK CIR, DOTHAN, AL 36303-3049
(334) 673-2242
(334) 793-8191
Mailing address
3118 ROSS CLARK CIR, DOTHAN, AL 36303-3049
(334) 673-2242
(334) 793-8191
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1592
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890009440
—
AL
Enumeration date
05/09/2006
Last updated
02/01/2010
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