| NPI | 1366774143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE D NICKENS Owner/Physical Therapist 601-898-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3573) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |