Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PTH1909 | AL |
NPI | 1124421235 |
---|---|
Provider Name | Dr. Dennis Wayne Fell |
First Address | Mobile, AL 36640-0277 |
Second Address | Mobile, AL 36688-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 03/12/2014 |