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General NPI Number Information
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NPI Number | 1952793309
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Entity Type | Organization
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Legal Business Name | HEAD TO TOE PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 665 S PEAR ORCHARD RD STE 114
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City | RIDGELAND
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State | MS
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Zip | 39157-4859
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Country | US
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Telephone | 769-235-6788
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Fax | 769-235-6763
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Provider Business Mailing Address
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Address Line | 665 S PEAR ORCHARD RD STE 114
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City | RIDGELAND
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State | MS
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Zip | 39157-4859
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Country | US
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Telephone | 769-235-6788
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Fax | 769-235-6763
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE SANDERS
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Credential | D.P.T
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Telephone | 601-624-5929
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT5617
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License Number State | MS
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