| NPI | 1578071122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY CHILES Credentialing Specalist 601-618-5120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |