| NPI | 1619152790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R P STATEN Superintendent Of Education 601-735-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MS NA) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |