Organization
STRONG STANCE ORTHOTICS & FITNESS
Active
Other names
Progressive Athletic Development
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEDRICK LANARD AGEE (OWNER)
(205) 249-9793
Entity
Organization
Contact information
Practice address
1529 BESSEMER RD, BIRMINGHAM, AL 35208-4016
(205) 249-9793
Mailing address
495 HEATHERWOOD DR, HOOVER, AL 35244-3221
(205) 249-9793
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
583
AL
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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