| NPI | 1063693802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS STURDAVANT Doctor 601-445-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MS 16798) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2007-11-23 |