| NPI | 1801984810 |
|---|---|
| Doing Business As | PIONEER SPORTS MEDICINE & PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | MELANIE L FAYARD Vice President 228-436-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO NONE REQUIRED) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-07-02 |