Basic Information
Provider Information
NPI: 1821336595
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRBY
FirstName: BRIAN
MiddleName: CHRISTOPHER
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
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Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4239331996
Practice Location
Address1: 5057 PINNACLE SQ
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352353216
CountryCode: US
TelephoneNumber: 2056559222
FaxNumber: 2056559233
Other Information
ProviderEnumerationDate: 01/30/2013
LastUpdateDate: 11/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X4556MSN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPTH9670ALY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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