Provider Demographics
NPI:1215248414
Name:CAIN, JARROD A (DPT)
Entity type:Individual
Prefix:MR
First Name:JARROD
Middle Name:A
Last Name:CAIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 SARALAND BLVD S
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-3633
Mailing Address - Country:US
Mailing Address - Phone:251-679-1995
Mailing Address - Fax:251-679-9282
Practice Address - Street 1:627 SARALAND BLVD S
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-3633
Practice Address - Country:US
Practice Address - Phone:251-679-1995
Practice Address - Fax:251-679-9282
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5855225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102L654213Medicare UPIN