Healthcare Provider Details

I. General information

NPI: 1326220252
Provider Name (Legal Business Name): NORTH HILLS PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 POPLAR SPRINGS DR SUITE A
MERIDIAN MS
39305-2678
US

IV. Provider business mailing address

4820 POPLAR SPRINGS DR SUITE A
MERIDIAN MS
39305-2678
US

V. Phone/Fax

Practice location:
  • Phone: 601-480-5503
  • Fax:
Mailing address:
  • Phone: 601-480-5503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT 3002
License Number StateMS

VIII. Authorized Official

Name: DANNY FRITTS
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential:
Phone: 601-480-5503