Organization
EASTERN SHORE PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MCKENZIE JONES DPT (CO-OWNER/PRESIDENT)
(251) 626-9052
Entity
Organization
Contact information
Practice address
6475 VAN BUREN ST, SUITE 102, DAPHNE, AL 36526-7585
(251) 626-9052
(251) 626-5384
Mailing address
PO BOX 2463, DAPHNE, AL 36526-2463
(251) 626-9052
(251) 626-5384
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTH847
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL2210
RAIL ROAL MEDICARE
AL
Enumeration date
05/22/2006
Last updated
04/25/2023
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