Healthcare Provider Details
I. General information
NPI: 1750613469
Provider Name (Legal Business Name): NAPOLI PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2631 MCINGVALE RD SUITE 130
HERNANDO MS
38632-5934
US
IV. Provider business mailing address
8293 MONTROSE DR
OLIVE BRANCH MS
38654-7907
US
V. Phone/Fax
- Phone: 662-796-1882
- Fax: 662-298-5181
- Phone: 662-796-1882
- Fax: 662-298-5181
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 3439 |
| License Number State | MS |
VIII. Authorized Official
Name:
GUIDANO
NAPOLI
Title or Position: PRESIDENT
Credential: MPT
Phone: 662-796-1882