| NPI | 1760843866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT GRANTHAM Owner/President 601-707-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MS PTA3839) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |