Organization
ICON PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI CONNELL (CREDENTIALING MANAGER)
(205) 259-3991
Entity
Organization
Contact information
Practice address
3156 SUNVIEW DR, VESTAVIA, AL 35243-5433
(205) 939-2914
Mailing address
3156 SUNVIEW DR, VESTAVIA, AL 35243-5433
(205) 939-2914
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
03/14/2013
Last updated
03/14/2013
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