| NPI | 1588781181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN B EVANS Managing Employee 601-984-5214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |