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Organization

MADISON PHYSICAL THERAPY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICTOR DALE RUSSELL R.P.T. (PRESIDENT)
(256) 325-3280
Entity
Organization

Contact information

Practice address
7693 HIGHWAY 72 W, MADISON, AL 35758-8750
(256) 325-3280
(256) 325-3281
Mailing address
7693 HIGHWAY 72 W, MADISON, AL 35758-8750
(256) 325-3280
(256) 325-3281

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTH255
AL
225100000X
Physical Therapist
Primary
PTH2852
AL
225100000X
Physical Therapist
PTH3369
AL

Other

Enumeration date
08/15/2006
Last updated
06/08/2010
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