Organization
THE THERAPY & WELLNESS GROUP, INC
Active
Other names
Advance Therapy & Performance Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A MASHBURN PT, OCS (PHYSICAL THERAPIST)
(334) 699-2348
Entity
Organization
Contact information
Practice address
3160 W MAIN ST, SUITE 1, DOTHAN, AL 36305-1185
(334) 699-2348
(334) 699-2347
Mailing address
3160 W MAIN ST, SUITE 1, DOTHAN, AL 36305-1185
(334) 699-2348
(334) 699-2347
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-32258
BCBS OF ALABAMA
AL
01
—
515-32301
BCBS OF ALABAMA
AL
01
—
515-36404
BCBS OF ALABAMA
AL
01
—
515-36412
BCBS OF ALABAMA
AL
Enumeration date
11/21/2006
Last updated
08/06/2007
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