| Legacy Outpatient Rehab Clinic | |
|
703 13th St, Phenix City, AL 36867-5038 | |
| (334) 448-5636 | |
| (334) 448-5637 |
| Full Name | Legacy Outpatient Rehab Clinic |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 703 13th St, Phenix City, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265764500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 3982 (Alabama) | Primary |
| Provider Name | Mary A Hudson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1720205776 PECOS PAC ID: 8921249145 Enrollment ID: I20130730000578 |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Outpatient Rehab Clinic 703 13th St, Phenix City, AL 36867-5038 Ph: (334) 448-5636 | Legacy Outpatient Rehab Clinic 703 13th St, Phenix City, AL 36867-5038 Ph: (334) 448-5636 |
Mrs. Kristin Edmonson Campbell, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3715 Us Highway 431 N, Phenix City, AL 36867 Phone: 334-732-2200 | |
Mrs. Jennifer Marie Widener, MCD, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1720 Knowles Rd, Phenix City, AL 36869 Phone: 334-291-0485 | |
Brandy Bratcher Bickley, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1720 Knowles Rd, Phenix City, AL 36869 Phone: 334-291-0485 | |
Mary Ann Hudson, M.ED.CCCSLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 703 13th St, Phenix City, AL 36867 Phone: 334-448-5636 Fax: 334-448-5637 |