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General NPI Number Information
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NPI Number | 1184768376
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Entity Type | Organization
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Legal Business Name | GENESIS PT AND REHAB SERVICES
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 227 HWY 51
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City | RIDGELAND
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State | MS
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Zip | 39157-4425
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Country | US
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Telephone | 601-898-4324
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Fax | 601-898-4325
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Provider Business Mailing Address
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Address Line | 227 HWY 51
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City | RIDGELAND
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State | MS
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Zip | 39157-4425
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Country | US
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Telephone | 601-898-4324
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Fax | 601-898-4325
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARGARET STEVENS JONES
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Credential |
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Telephone | 601-898-4324
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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 | PT0695
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT3765
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License Number State | MS
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