Organization
PROMISE PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN PRICE GRICE III PT, ATC (PRESIDENT)
(334) 358-2201
Entity
Organization
Contact information
Practice address
640 MCQUEEN SMITH RD N, PRATTVILLE, AL 36066-7511
(334) 358-2201
(334) 358-2236
Mailing address
640 MCQUEEN SMITH RD N, PRATTVILLE, AL 36066-7511
(334) 358-2201
(334) 358-2236
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT1534
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51515426
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/12/2006
Last updated
06/07/2013
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