| NPI | 1013461755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEDRIC KENNARD DONALDSON Owner 601-918-6980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AL PTH6362) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |