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General NPI Number Information
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NPI Number | 1083860688
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Entity Type | Organization
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Legal Business Name | COMPLETE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 809 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39202-2604
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Country | US
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Telephone | 601-354-5722
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Fax | 601-354-5322
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Provider Business Mailing Address
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Address Line | 148 SONNETT CIR
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City | MADISON
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State | MS
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Zip | 39110-7653
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Country | US
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Telephone | 601-853-9291
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Fax | 601-354-5322
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | NIKI SINGLETARY
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Credential | PT
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Telephone | 601-940-5730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT3460
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License Number State | MS
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