| NPI | 1821477167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WAYNE GRANTHAM Owner/Physical Therapist 601-906-3718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MS PT3612) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |