Healthcare Provider Details
I. General information
NPI: 1154992014
Provider Name (Legal Business Name): CARWILE REHAB & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2021
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 BETHLEHEM CHURCH RD
KILMICHAEL MS
39747-9445
US
IV. Provider business mailing address
600 BETHLEHEM CHURCH RD
KILMICHAEL MS
39747-9445
US
V. Phone/Fax
- Phone: 662-230-0771
- Fax:
- Phone: 662-230-0771
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTY
CARWILE
Title or Position: OWNER
Credential: DPT
Phone: 662-230-0771