| NPI | 1063559755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY KEITH VUNCANNON Co Owner 662-424-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MS PT3039) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-06-23 |