| NPI | 1952793309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE SANDERS Owner 601-624-5929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MS PT5617) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2017-11-29 |