Provider Demographics
NPI:1366985756
Name:BALLARD, REBECCA CORBMAN (DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CORBMAN
Last Name:BALLARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:KATHRYN
Other - Last Name:CORBMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials: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:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:210 FIELDSTOWN RD STE 108
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2418
Practice Address - Country:US
Practice Address - Phone:205-285-2180
Practice Address - Fax:205-285-2181
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist