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General NPI Number Information
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NPI Number | 1225924590
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Entity Type | Organization
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Legal Business Name | GO THERAPY LLC
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Dates
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Enumeration Date | 06/14/2025
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 6161 HIGHWAY 547
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City | PORT GIBSON
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State | MS
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Zip | 39150-2912
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Country | US
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Telephone | 601-529-9084
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Fax | 601-994-6329
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Provider Business Mailing Address
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Address Line | 6161 HIGHWAY 547
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City | PORT GIBSON
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State | MS
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Zip | 39150-2912
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Country | US
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Telephone | 601-529-9084
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Fax | 601-994-6329
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUMMER FIFE
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Credential |
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Telephone | 601-529-9084
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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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