| NPI | 1154247310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MATTHEW WUERDEMAN Physical Therapist 601-842-5197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2026-06-24 |
| Last Update Date | 2026-08-11 |