Provider Demographics
NPI:1316995004
Name:WINN, PRESTON J
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:J
Last Name:WINN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2583 BRIDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3916
Mailing Address - Country:US
Mailing Address - Phone:205-620-5024
Mailing Address - Fax:
Practice Address - Street 1:1808 GADSDEN HWY
Practice Address - Street 2:SUITE 136
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3139
Practice Address - Country:US
Practice Address - Phone:205-655-8866
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH3685OtherSTATE LICENSE NUMBER
AL51528354OtherBC/BS IDENTIFIER NUMBER
ALPTH3685OtherSTATE LICENSE NUMBER