Healthcare Provider Details
I. General information
NPI: 1679565949
Provider Name (Legal Business Name): REHAB AT WORK OF SOUTH MISSISSIPPI
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
65 DUTCH LN
COLUMBUS MS
39702-5523
US
IV. Provider business mailing address
500 HILL ST
ELLISVILLE MS
39437-2526
US
V. Phone/Fax
- Phone: 662-241-4545
- Fax: 662-241-4025
- Phone: 601-477-3060
- Fax: 601-477-3070
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAWN
POUNDERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 662-241-4545