=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750613469
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAPOLI PHYSICAL THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2010
-----------------------------------------------------
Last Update Date | 02/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2631 MCINGVALE RD SUITE 130
-----------------------------------------------------
City | HERNANDO
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38632-5934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-796-1882
-----------------------------------------------------
Fax | 662-298-5181
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8293 MONTROSE DR
-----------------------------------------------------
City | OLIVE BRANCH
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38654-7907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-796-1882
-----------------------------------------------------
Fax | 662-298-5181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | GUIDANO NAPOLI
-----------------------------------------------------
Credential | MPT
-----------------------------------------------------
Telephone | 662-796-1882
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 3439
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------