Healthcare Provider Details

I. General information

NPI: 1306246541
Provider Name (Legal Business Name): UNITED REHAB ASSOCIATES OF CLINTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 SPRINGRIDGE RD SUITE B
CLINTON MS
39056-5641
US

IV. Provider business mailing address

590 SPRINGRIDGE RD SUITE B
CLINTON MS
39056-5641
US

V. Phone/Fax

Practice location:
  • Phone: 601-473-2317
  • Fax: 601-473-2327
Mailing address:
  • Phone: 601-473-2317
  • Fax: 601-473-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID A PARKER II
Title or Position: OWNER
Credential:
Phone: 601-382-3699