Individual
JUSTIN HARGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15041 HIGHWAY 43, RUSSELLVILLE, AL 35653-1973
(256) 331-0070
(256) 331-0054
Mailing address
1908 FLINT RD SE, DECATUR, AL 35601-6031
(256) 340-9708
(256) 340-9624
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PTH7160
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
06/23/2014
Last updated
06/23/2014
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