| |
540 Hughes Rd Ste 8, Madison, AL 35758-8959 | |
(256) 285-4352 | |
(256) 963-9347 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 540 Hughes Rd Ste 8, Madison, Alabama |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235919473 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Jon M Dockery |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1588080857 PECOS PAC ID: 4385877471 Enrollment ID: I20140424002054 |
Mailing Address | Practice Location Address |
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401 Hughes Rd Ste 2, Madison, AL 35758-1144 Ph: (256) 285-4352 | 540 Hughes Rd Ste 8, Madison, AL 35758-8959 Ph: (256) 285-4352 |