Provider Demographics
NPI:1538578158
Name:DAVIES, DEIDRA STEVENSON (PT, DPT)
Entity type:Individual
Prefix:
First Name:DEIDRA
Middle Name:STEVENSON
Last Name:DAVIES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 GADSDEN HWY
Mailing Address - Street 2:SUITE 138
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3139
Mailing Address - Country:US
Mailing Address - Phone:205-655-8866
Mailing Address - Fax:205-655-8868
Practice Address - Street 1:3415 INDEPENDENCE DR
Practice Address - Street 2:SUITE 219
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-8314
Practice Address - Country:US
Practice Address - Phone:205-802-8537
Practice Address - Fax:205-802-8539
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist