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General NPI Number Information
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NPI Number | 1558459594
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Entity Type | Organization
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Legal Business Name | NATCHEZ REHAB & SPORTS SPECIALISTS
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 55 SGT PRENTISS DR SUITE 8
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City | NATCHEZ
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State | MS
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Zip | 39120-4782
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Country | US
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Telephone | 601-446-8764
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Fax | 601-446-8745
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Provider Business Mailing Address
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Address Line | 55 SGT PRENTISS DR SUITE 8
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City | NATCHEZ
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State | MS
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Zip | 39120-4782
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Country | US
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Telephone | 601-446-8764
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Fax | 601-446-8745
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Authorized Official
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Title or Position | PHYSICAL THERAPISTS
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Name | MRS. LARA KATI WOODARD
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Credential | MPT
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Telephone | 601-446-8764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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