| NPI | 1558664250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J RICHE Member 601-573-9974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MS PTA2491) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MS TA1991) |
| 224Z00000X Occupational Therapy Assistant (Licence: MS TA2342) | |
| 225200000X Physical Therapy Assistant (Licence: MS PTA2698) | |
| Enumeration Date | 2010-12-19 |
| Last Update Date | 2010-12-19 |