Individual
MARY FORMBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
400 PAUL BRYANT DRIVE E, TUSCALOOSA, AL 35401-2009
(205) 345-0192
(205) 247-2194
Mailing address
305 PAUL BRYANT DRIVE E, TUSCALOOSA, AL 35401-2055
(205) 345-0192
(205) 247-2194
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
02501
MD
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
2717
AL
Other
Enumeration date
02/14/2008
Last updated
10/31/2008
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