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General NPI Number Information
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NPI Number | 1861522427
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Entity Type | Organization
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Legal Business Name | HATTIEBURG PHYSICAL THERAPY CENTER
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 52 98 PLACE BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-8603
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Country | US
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Telephone | 601-296-0199
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Fax | 601-296-0189
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Provider Business Mailing Address
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Address Line | 6068 U S HIGHWAY 98 SUITE 1196
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City | HATTIESBURG
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State | MS
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Zip | 39402-8883
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Country | US
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Telephone | 601-296-0199
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Fax | 601-296-0189
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM T COCHRAN
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Credential | MPT
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Telephone | 601-296-0199
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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 |
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License Number State |
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