Organization
LIFESTYLE THERAPEUTIX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD TITUS GOODMAN III PT (OWNER)
(256) 348-2144
Entity
Organization
Contact information
Practice address
4825 UNIVERSITY SQ, SUITE 9, HUNTSVILLE, AL 35816-1826
(256) 348-2144
Mailing address
1660 OSCAR PATTERSON RD, NEW MARKET, AL 35761-9418
(256) 348-2144
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTH4539
AL
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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