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General NPI Number Information
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NPI Number | 1316707946
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Entity Type | Organization
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Legal Business Name | REGAIN PELVIC PHYSICAL THERAPY, LLC.
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 4715 24TH PL STE A
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City | MERIDIAN
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State | MS
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Zip | 39305-1686
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Country | US
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Telephone | 601-531-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 4715 24TH PL STE A
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City | MERIDIAN
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State | MS
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Zip | 39305-1686
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Country | US
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Telephone | 601-531-3599
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Fax | 601-531-3786
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Authorized Official
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Title or Position | OWNER/ PHYSICAL THERAPIST
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Name | DR. ALISHA MICHALLE MASSEY
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Credential |
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Telephone | 601-481-5815
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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 |
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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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