Individual
MISS LEANNE R CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
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) 824-6243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1824
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51515298
BLUE CROSS BLUE SHIELD
AL
Enumeration date
11/08/2006
Last updated
07/08/2007
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