Basic Information
Provider Information
NPI: 1366874869
EntityType: 2
ReplacementNPI:  
OrganizationName: DRAYER PHYSICAL THERAPY-ALABAMA, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: REHAB AT WORK
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1781B COMMONS NORTH LOOP
Address2:  
City: TUSCALOOSA
State: AL
PostalCode: 354063577
CountryCode: US
TelephoneNumber: 2057520845
FaxNumber: 2057520866
Practice Location
Address1: 1781B COMMONS NORTH LOOP
Address2:  
City: TUSCALOOSA
State: AL
PostalCode: 354063577
CountryCode: US
TelephoneNumber: 2057520845
FaxNumber: 2057520866
Other Information
ProviderEnumerationDate: 08/07/2013
LastUpdateDate: 08/16/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DRAYER
AuthorizedOfficialFirstName: LUKE
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: CHAIRMAN & CEO
AuthorizedOfficialTelephone: 7172202100
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home