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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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