| NPI | 1780908475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARON WALTERS Manager 601-573-9712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2013-12-11 |