Healthcare Provider Details

I. General information

NPI: 1013213594
Provider Name (Legal Business Name): RELIANT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 HIGHWAY 80 E
PEARL MS
39208-4232
US

IV. Provider business mailing address

105 SUMMIT GRV
BRANDON MS
39047-7384
US

V. Phone/Fax

Practice location:
  • Phone: 769-777-4400
  • Fax: 769-777-4401
Mailing address:
  • Phone: 601-906-9052
  • 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. RICHARD ADAM BELL
Title or Position: PRESIDENT/OWNER
Credential: DPT
Phone: 601-906-9052