Organization
IMC OF ALABAMA
Active
Parent organization
COSPT
Organization subpart
Yes
Provider details
NPI number
Legal business name
COSPT
Authorized official
MR. JOHN MARK MILLER PT, DIP MDT (OWNER/PRESIDENT)
(850) 656-1837
Entity
Organization
Contact information
Practice address
5101 21ST STREET, TUSCALOOSA, AL 35401
(850) 656-1837
(850) 877-2917
Mailing address
2615 CENTENNIAL BLVD., SUITE 101, TALLAHASSEE, FL 32308-0536
(850) 656-1837
(850) 877-2917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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