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Organization

RESTORE FLORALA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE B KNOWLES (ADMINISTRATOR)
(205) 942-6820
Entity
Organization

Contact information

Practice address
23621 GOLDENROD AVE, FLORALA, AL 36442-3652
(205) 942-6820
Mailing address
245 CAHABA VALLEY PKWY, PELHAM, AL 35124-2216

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011220
BCBS
AL
01
11968
AL STATE BORAD OF HEALTH
AL
Enumeration date
03/14/2016
Last updated
03/14/2016
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