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General NPI Number Information
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NPI Number | 1417280009
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Entity Type | Organization
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Legal Business Name | MID SOUTH REHAB OUTPATIENT CLINIC LLC
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 599C STEED RD
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City | RIDGELAND
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State | MS
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Zip | 39157-1707
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Country | US
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Telephone | 888-861-2349
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Fax |
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Provider Business Mailing Address
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Address Line | 599C STEED RD
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City | RIDGELAND
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State | MS
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Zip | 39157-1707
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Country | US
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Telephone | 888-861-2349
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Fax |
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | MR. STEVEN L COLE
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Credential |
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Telephone | 888-861-2349
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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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