Organization
ACTIVE HEALTH AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IRA LANE BLONDHEIM PT (OWNER, THERAPIST)
(334) 279-5757
Entity
Organization
Contact information
Practice address
3442 EASTDALE CIR, MONTGOMERY, AL 36117-2163
(334) 279-5757
(334) 279-1257
Mailing address
3442 EASTDALE CIR, MONTGOMERY, AL 36117-2163
(334) 279-5757
(334) 279-1257
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTH3183
AL
Other
Enumeration date
12/21/2006
Last updated
08/22/2020
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