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General NPI Number Information
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NPI Number | 1497948152
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Entity Type | Organization
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Legal Business Name | STARKVILLE PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 100B4 GT THAMES DRIVE
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City | STARKVILLE
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State | MS
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Zip | 39759-8836
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Country | US
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Telephone | 662-615-1870
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Fax | 662-615-1871
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Provider Business Mailing Address
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Address Line | 100B4 GT THAMES DRIVE
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City | STARKVILLE
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State | MS
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Zip | 39759-8836
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Country | US
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Telephone | 662-615-1870
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Fax | 662-615-1871
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. HILARY H RENDON
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Credential | PT
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Telephone | 662-615-1870
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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 | PT 1169
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License Number State | MS
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