| NPI | 1013454065 |
|---|---|
| Former Legal Business Name | ALLY THERAPY SPECIALIST |
| Entity Type | Organization |
| Authorized Contact | KELVIN MOORE Manager 662-288-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MS OT2229) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2023-04-12 |