| NPI | 1609127083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BUTCH SLAUGHTER Owner 601-906-0386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics |
| 2251P0200X Physical Therapist Pediatrics | |
| 2251S0007X Physical Therapist Sports | |
| 225X00000X Occupational Therapist | |
| 225XG0600X Occupational Therapist Gerontology (Licence: MS PT0161) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |