Healthcare Provider Details

I. General information

NPI: 1487590964
Provider Name (Legal Business Name): THERAFIX PHYSICAL THERAPY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 COUNTY ROAD 367
NEW ALBANY MS
38652-7011
US

IV. Provider business mailing address

1002 COUNTY ROAD 367
NEW ALBANY MS
38652-7011
US

V. Phone/Fax

Practice location:
  • Phone: 662-544-7274
  • Fax:
Mailing address:
  • Phone: 662-544-7274
  • 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: MR. CARTER UMALI ORDAZ
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: PT
Phone: 662-544-7274