Healthcare Provider Details
I. General information
NPI: 1952605602
Provider Name (Legal Business Name): ARTHUR KENDALL CAUSEY JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 CLINTON PKWY
CLINTON MS
39056-4730
US
IV. Provider business mailing address
108 CLINTON PKWY
CLINTON MS
39056-4730
US
V. Phone/Fax
- Phone: 601-926-2018
- Fax: 601-924-9746
- Phone: 601-926-2018
- Fax: 601-924-9746
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT2021 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: