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General NPI Number Information
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NPI Number | 1962125666
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Entity Type | Organization
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Legal Business Name | COMPLETE MOTION PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 350 W WOODROW WILSON AVE STE 370C
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City | JACKSON
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State | MS
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Zip | 39213-7692
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Country | US
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Telephone | 601-982-3065
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Fax | 601-982-3066
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Provider Business Mailing Address
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Address Line | 350 W WOODROW WILSON AVE STE 370C
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City | JACKSON
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State | MS
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Zip | 39213-7692
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Country | US
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Telephone | 601-982-3065
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Fax | 601-982-3066
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Authorized Official
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Title or Position | CO -OWNER/PT
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Name | MONIQUE THOMPSON
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Credential | DPT
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Telephone | 601-982-3065
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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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