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 |