Organization
HARTFORD REHAB AND WELNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH LYNN BRUNSON LPTA (OWNER/MANAGER)
(334) 588-2323
Entity
Organization
Contact information
Practice address
102 S 4TH AVE, HARTFORD, AL 36344-1615
(334) 588-2323
Mailing address
102 S 4TH AVE, HARTFORD, AL 36344-1615
(334) 588-2323
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA3669
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-46442
BLUE BROSS BLUE SHEILD
AL
Enumeration date
05/12/2008
Last updated
05/12/2008
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