Healthcare Provider Details

I. General information

NPI: 1134043904
Provider Name (Legal Business Name): BRANDON RIMMER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N JEFFERSON ST
HOUSTON MS
38851-2220
US

IV. Provider business mailing address

222 N JEFFERSON ST
HOUSTON MS
38851-2220
US

V. Phone/Fax

Practice location:
  • Phone: 662-456-1065
  • Fax: 662-456-1269
Mailing address:
  • Phone: 662-456-1065
  • Fax: 662-456-1269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT8219
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: