Individual
CHARLES LIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19195 N 3RD ST, CITRONELLE, AL 36522-4015
(251) 866-0464
(251) 866-0466
Mailing address
251 JOHNSTON ST SE STE 300, DECATUR, AL 35601-2515
(256) 350-1764
(256) 350-7757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH7679
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
08/06/2015
Last updated
08/06/2015
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