Basic Information
| Provider Information | |||||||||
| NPI: | 1760673586 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALDRIDGE PHYSICAL THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 392573 | ||||||||
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| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152519573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245845739 | ||||||||
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| Practice Location | |||||||||
| Address1: | 163 ALABAMA ST | ||||||||
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| City: | ALEXANDER CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350101934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342392608 | ||||||||
| FaxNumber: | 3346591477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2007 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | REDFERN | ||||||||
| AuthorizedOfficialFirstName: | MELANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 4165672400 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PHOENIX REHABILITATION AND HEALTH SERVICES, INC | ||||||||
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| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.