| NPI | 1669509352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY D MONCURE Administer PT 601-437-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MS 256591) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |