| NPI | 1821778713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA WHALUM Occupational Therapist 662-536-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261Q00000X |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2024-01-30 |