Derwin Barnard Cantrell, PT, DPT
Individual provider Active NPI Physical Therapist · Jacksonville, AL
NPI 1689289191 · NPPES record last updated Sep 11, 2020
Key facts
- NPI
- 1689289191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTH9945 (AL)
- Practice address
- 1622 Church Ave SE
Jacksonville, AL 36265-3200 - Phone
- (256) 365-2792
- Fax
- (256) 937-7457
- NPI assigned
- Sep 11, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH9945 | AL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH9945 | AL | Yes |
Addresses
Primary practice location
1622 Church Ave SE
Jacksonville, AL 36265-3200
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217
Other providers in Jacksonville, AL
- Calhoun Emergency Group LLC
- Naquisha Calhoun
- John Micah Calvert
- Camille'S Counsolations LLC
- Kenneth Wayne Campbell
- Juda Carter
- Ginger L Caudell
- Anmarie Chandler
- Chelsea Nicole Chandler
- David Glenn Chandler
All providers in Jacksonville, AL · Physical Therapist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.