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General NPI Number Information
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NPI Number | 1063693802
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Entity Type | Organization
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Legal Business Name | REHABILITATION SOLUTIONS, PLLC
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 1104 W 1ST ST SUITE 6
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City | LAUREL
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State | MS
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Zip | 39440-4357
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Country | US
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Telephone | 601-425-0001
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Fax | 601-425-9299
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Provider Business Mailing Address
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Address Line | 1104 W 1ST ST SUITE 6
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City | LAUREL
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State | MS
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Zip | 39440-4357
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Country | US
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Telephone | 601-425-0001
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Fax | 601-425-9299
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. THOMAS STURDAVANT
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Credential | M.D.
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Telephone | 601-445-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 16798
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License Number State | MS
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