Organization
THERAPY SOUTH - GLUCKSTADT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH KELLY (CREDENTIALING SPECIALIST)
(205) 745-3660
Entity
Organization
Contact information
Practice address
1716 US 51, STE N, MADISON, MS 39110
(601) 499-5780
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
—
6014995780
PHONE NUMBER
MS
Enumeration date
05/09/2019
Last updated
06/17/2019
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