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General NPI Number Information
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NPI Number | 1487506200
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Entity Type | Organization
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Legal Business Name | WHITESIDE PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 2304 19TH ST STE 203
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City | GULFPORT
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State | MS
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Zip | 39501-2912
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Country | US
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Telephone | 228-326-8240
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Fax |
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Provider Business Mailing Address
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Address Line | 725 OLEANDER LN
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City | BILOXI
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State | MS
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Zip | 39532-4131
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Country | US
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Telephone | 228-326-8240
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH WHITESIDE
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Credential |
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Telephone | 228-326-8240
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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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