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General NPI Number Information
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NPI Number | 1215525118
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY CENTER OF OCEAN SPRINGS LLC
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Dates
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Enumeration Date | 01/06/2021
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 433 BROAD ST
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City | COLUMBIA
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State | MS
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Zip | 39429-3404
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Country | US
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Telephone | 601-444-0037
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Fax | 601-444-0033
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Provider Business Mailing Address
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Address Line | 900 HOLCOMB BLVD STE A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DALE MICHAEL YAKE
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Credential |
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Telephone | 678-403-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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