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General NPI Number Information
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NPI Number | 1962295576
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Entity Type | Organization
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Legal Business Name | DYNAMIX PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 2035 E SHILOH RD STE A
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City | CORINTH
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State | MS
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Zip | 38834-3726
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Country | US
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Telephone | 731-613-2214
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 996
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City | MILAN
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State | TN
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Zip | 38358-0996
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Country | US
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Telephone | 731-613-2214
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DORA M ANDERSON
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Credential |
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Telephone | 731-613-2214
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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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