Organization
TALLASSEE REHAB PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA VAN ETTEN PT (PT OWNER)
(334) 799-5853
Entity
Organization
Contact information
Practice address
1000 FRIENDSHIP RD, TALLASSEE, AL 36078-1265
(334) 283-8032
(334) 283-1136
Mailing address
1000 FRIENDSHIP RD, TALLASSEE, AL 36078-1265
(334) 283-8032
(334) 283-1136
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1054269
FIRST HEALTH
AL
01
—
1487373
CIGNA
—
01
—
168028100
US DEPT OF LABOR OWCP ACS
—
01
—
382573
ACN GROUP
—
01
—
45311
HEALTHSPRING OF AL
AL
05
—
529907700
—
AL
01
—
6410033
UNITED HEALTHCARE
AL
Enumeration date
07/06/2006
Last updated
04/24/2025
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