| NPI | 1083643761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRIAN HAIMSON President 601-442-9654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MS 05227) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT0333) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2009-09-16 |