Provider Demographics
NPI:1487929071
Name:HUMPHREY, ELEANOR CATHERINE (PT)
Entity type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:CATHERINE
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:CATHERINE
Other - Last Name:NEVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2604 VESTBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4528
Mailing Address - Country:US
Mailing Address - Phone:205-879-6447
Mailing Address - Fax:205-879-6397
Practice Address - Street 1:402 OFFICE PARK DR STE 260
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-3100
Practice Address - Country:US
Practice Address - Phone:205-879-6447
Practice Address - Fax:205-879-6397
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1056225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist