Provider Demographics
NPI:1902047384
Name:FASSBENDER, PATRICIA A (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:FASSBENDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6450
Mailing Address - Country:US
Mailing Address - Phone:866-401-3057
Mailing Address - Fax:318-868-6430
Practice Address - Street 1:1601 CENTER ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1541
Practice Address - Country:US
Practice Address - Phone:251-410-5437
Practice Address - Fax:251-415-8578
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2023-06-13
Deactivation Date:2023-05-23
Deactivation Code:
Reactivation Date:2023-06-13
Provider Licenses
StateLicense IDTaxonomies
ALPTH420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist