| NPI | 1396903209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY K BRUNSON Office Manager 601-296-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MS OT0493) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT0932) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-09-11 |