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General NPI Number Information
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NPI Number | 1194979120
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Entity Type | Organization
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Legal Business Name | REGIONAL REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 615 PEGRAM DR
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City | TUPELO
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State | MS
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Zip | 38801-6321
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Country | US
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Telephone | 662-842-1891
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Fax | 662-840-0941
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Provider Business Mailing Address
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Address Line | 615 PEGRAM DR
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City | TUPELO
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State | MS
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Zip | 38801-6321
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Country | US
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Telephone | 662-842-1891
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Fax | 662-840-0941
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | MS. VICKI BUTLER GAILLARD
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Credential | CCC-A
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Telephone | 662-842-1891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A0737
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License Number State | MS
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