| NPI | 1538473368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIE LEON TINGLE Owner/Director 228-769-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3068) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2014-11-10 |