Individual
JUSTIN EIDSMOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1241 PT MALLARD PKWY STE 201, DECATUR, AL 35601-6555
(256) 350-9750
Mailing address
800 CRESCENT CENTRE DR STE 300, FRANKLIN, TN 37067-7285
(615) 416-0199
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH8822
AL
Other
Enumeration date
02/26/2018
Last updated
10/04/2019
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