Organization
MY 180 HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLTON CLAUDE WILSON SR. (PRESIDENT)
(256) 226-5789
Entity
Organization
Contact information
Practice address
1618 SLAUGHTER ROAD, MADISON, MADISON, AL 35758
(286) 226-5789
Mailing address
1618 SLAUGHTER ROAD, SUITE C, MADISON, AL 35758
(256) 226-5789
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
AL
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
AL
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/07/2015
Last updated
02/22/2016
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