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General NPI Number Information
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NPI Number | 1306600341
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Entity Type | Organization
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Legal Business Name | HOMETOWN THERAPY LLC
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 2509 OLD BRANDON RD STE C
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City | PEARL
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State | MS
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Zip | 39208-4610
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Country | US
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Telephone | 601-487-6814
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Fax | 601-487-6815
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Provider Business Mailing Address
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Address Line | PO BOX 54163
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City | PEARL
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State | MS
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Zip | 39288-4163
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Country | US
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Telephone | 601-487-6814
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Fax | 601-487-6815
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRAIG NELSON HOWARD
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Credential | DPT
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Telephone | 601-497-4469
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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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