Provider Demographics
NPI:1306925698
Name:MUSICK, DANA
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:MUSICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6272 COUNTY HIGHWAY 21
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:AL
Mailing Address - Zip Code:35980-7105
Mailing Address - Country:US
Mailing Address - Phone:205-466-7875
Mailing Address - Fax:
Practice Address - Street 1:4517 SOUTHLAKE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-3281
Practice Address - Country:US
Practice Address - Phone:205-988-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1046OtherLICENSE#