Healthcare Provider Details

I. General information

NPI: 1851066989
Provider Name (Legal Business Name): IN TOUCH PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 LAKELAND DRIVE SUITE 100 E
JACKSON MS
39216-4725
US

IV. Provider business mailing address

1425 LAKELAND DR STE 100E
JACKSON MS
39216-4725
US

V. Phone/Fax

Practice location:
  • Phone: 601-790-0250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: SHARMON R ROBINSON
Title or Position: OWNER AND PT
Credential: PT, DPT
Phone: 601-790-0250