| NPI | 1720282247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA CARTER Office Manager 662-247-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT1324) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT3777) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |