| NPI | 1790074631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY MCCOY Administrator 601-657-1000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MS PTA 4044) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |