Individual
MR. JON PAUL CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, ATC
Contact information
Practice address
2090 COLUMBIANA RD, SUITE 1000, VESTAVIA, AL 35216-2153
(205) 824-0610
(205) 824-6263
Mailing address
335 NEW HOPE MOUNTAIN RD, INDIAN SPRINGS, AL 35124-3719
(205) 824-0610
(205) 824-6263
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3279
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51516141
BLUE CROSS BLUE SHIELD
AL
Enumeration date
11/08/2006
Last updated
07/08/2007
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