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General NPI Number Information
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NPI Number | 1700338852
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC PILATES, LLC
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 101 S LAFAYETTE ST SUITE 17
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City | STARKVILLE
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State | MS
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Zip | 39759-2914
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Country | US
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Telephone | 662-242-3789
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S LAFAYETTE ST SUITE 17
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City | STARKVILLE
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State | MS
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Zip | 39759-2914
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Country | US
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Telephone | 662-242-3789
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KATIE CAIN LANGLEY
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Credential | PT
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Telephone | 662-242-3789
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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 | PT3788
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License Number State | MS
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