Organization
IMPACT REHABILITATION AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CHADWICK (OWNER)
(205) 621-3077
Entity
Organization
Contact information
Practice address
101 CARRINGTON LN STE C, CALERA, AL 35040-5439
(205) 621-3077
(205) 621-3788
Mailing address
PO BOX 1694, CALERA, AL 35040-1694
(205) 621-3077
(205) 621-3788
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438219695
TRI-CARE
AL
01
—
50727
HEALTH SPRING
AL
01
—
51534667
CHRISTY BCBS
AL
01
—
51535738
SUZI BCBS
AL
01
—
AETNA
7176438
AL
Enumeration date
08/21/2006
Last updated
04/22/2009
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