Organization
PROHEALTH PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY WISNER (COO)
(256) 997-9991
Entity
Organization
Contact information
Practice address
1102 DEKALB PLAZA BLVD SW, FORT PAYNE, AL 35967-4868
(256) 997-9991
(256) 997-9950
Mailing address
1102 DEKALB PLAZA BLVD SW, FORT PAYNE, AL 35967-4868
(256) 997-9991
(256) 997-9950
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
AL
Other
Enumeration date
07/26/2007
Last updated
10/09/2009
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