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General NPI Number Information
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NPI Number | 1336708098
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Entity Type | Organization
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Legal Business Name | REACH THERAPEUTIC SOLUTIONS LLC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 363 HIGHLAND COLONY PKWY
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City | RIDGELAND
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State | MS
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Zip | 39157-6035
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Country | US
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Telephone | 601-398-0171
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Fax | 601-398-0983
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Provider Business Mailing Address
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Address Line | 109 DIAMONDBACK LN
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City | BRANDON
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State | MS
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Zip | 39047-6060
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Country | US
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Telephone | 601-316-7221
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Fax | 601-202-3063
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Authorized Official
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Title or Position | OWNER
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Name | LISA BRYANT
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Credential | PT, DPT, CEAS
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Telephone | 601-316-7221
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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 |
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License Number State |
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