Provider Demographics
NPI:1134751001
Name:BEVEL, ELAINE SUSAN LIAW (PT, DPT)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:SUSAN LIAW
Last Name:BEVEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:SUSAN
Other - Last Name:LIAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7212
Mailing Address - Fax:
Practice Address - Street 1:651 MAIN ST STE 119
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2790
Practice Address - Country:US
Practice Address - Phone:205-608-3113
Practice Address - Fax:205-608-3036
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist