Provider Demographics
NPI:1386486769
Name:PTP LAB
Entity type:Organization
Organization Name:PTP LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:256-708-0329
Mailing Address - Street 1:1716 MEADOWBROOK DR SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-9563
Mailing Address - Country:US
Mailing Address - Phone:256-708-0329
Mailing Address - Fax:205-543-6910
Practice Address - Street 1:419 MAIN AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3348
Practice Address - Country:US
Practice Address - Phone:256-708-0329
Practice Address - Fax:205-543-6910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy