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General NPI Number Information
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NPI Number | 1336367812
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Entity Type | Individual
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Provider Name | DANNY THOMAS FRITTS
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 4820 POPLAR SPRINGS DR SUITE A
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City | MERIDIAN
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State | MS
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Zip | 39305-2678
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Country | US
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Telephone | 601-480-5503
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Fax |
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Provider Business Mailing Address
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Address Line | 9099A COLLINSVILLE RD
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City | COLLINSVILLE
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State | MS
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Zip | 39325-9779
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Country | US
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Telephone | 601-480-5503
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT3002
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License Number State | MS
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