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General NPI Number Information
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NPI Number | 1922542646
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Entity Type | Organization
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Legal Business Name | ANCHOR REHABILITATION LLC
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 2106 S TATE ST STE E
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City | CORINTH
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State | MS
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Zip | 38834-7913
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Country | US
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Telephone | 662-415-2782
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 S TATE ST STE E
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City | CORINTH
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State | MS
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Zip | 38834-7913
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Country | US
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Telephone | 662-415-2782
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | PATRICK WAYNE HINTON
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Credential | DPT
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Telephone | 662-415-2782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2957
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | S3887
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5534
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License Number State | MS
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