Organization
ESPT FAIRHOPE LLC
Active
Organization
ESPT FAIRHOPE LLC
Active
Other names
Eastern Shore Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN M LACKEY PT (PRESIDENT)
(251) 928-0600
Entity
Organization
Contact information
Practice address
924 PLANTATION BLVD STE B, FAIRHOPE, AL 36532-7308
(251) 928-0600
Mailing address
164 PECAN AVE, FAIRHOPE, AL 36532-1226
(251) 401-0426
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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