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General NPI Number Information
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NPI Number | 1669688891
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Entity Type | Organization
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Legal Business Name | NORTH BAY THERAPY LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 1990 POPPS FERRY RD
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City | BILOXI
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State | MS
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Zip | 39532-2015
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Country | US
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Telephone | 228-385-9000
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Fax | 228-388-1419
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Provider Business Mailing Address
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Address Line | 1990 POPPS FERRY RD
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City | BILOXI
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State | MS
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Zip | 39532-2015
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Country | US
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Telephone | 228-385-9000
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Fax | 228-388-1419
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. RODNEY KEITH GANEY
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Credential | DPT, SCS, ATC
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Telephone | 228-385-9000
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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 | PT0841
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License Number State | MS
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