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General NPI Number Information
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NPI Number | 1740378140
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Entity Type | Individual
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Provider Name | SUSAN JENKINS HOYLE P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 4850 GOODMAN RD STE 110
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City | OLIVE BRANCH
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State | MS
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Zip | 38654
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Country | US
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Telephone | 662-349-6712
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Fax | 662-349-6782
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Provider Business Mailing Address
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Address Line | 4850 GOODMAN RD STE 110
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-7906
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Country | US
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Telephone | 662-349-6712
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Fax | 662-349-6782
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT0682
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License Number State | MS
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