MEDICARE: 2083 THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1109164	OTHER	MS	BUSINESS LICENSE

General Provider Information

NPI Number	:	1528577392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	2083 THERAPY, LLC

Provider Business Mailing Address
First Line	:	110 PIONEER WAY
Second Line	:
City	:	MAGEE
State	:	MS
Zip	:	39111-5501
Country	:	US
Telephone Number	:	601-849-6440
Fax Number	:

Provider Business Practice Location Address
First Line	:	513 W MARION AVE
Second Line	:
City	:	CRYSTAL SPRINGS
State	:	MS
Zip	:	39059-2748
Country	:	US
Telephone Number	:	601-281-5930
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOSEPH MCNULTY IV
Credential	:
Telephone Number	:	601-849-6440

Provider Enumeration Date	:	09/25/2017
Last Update Date	:	09/25/2017

Similar Medicare Providers

1588042451 — MEDICOMP, INC
Practice Location Address:

513 W MARION AVE
CRYSTAL SPRINGS, MS
39059-2748

Practice Phone: 888-976-2667
Practice Fax: 601-824-8828

1982118188 — ENDURACARE ACUTE CARE SERVICES LLC
Practice Location Address:

513 W MARION AVE
CRYSTAL SPRINGS, MS
39059-2748

Practice Phone: 601-281-5930
Practice Fax: 601-281-5964

1134360720 — MRS. SUZANNE ANTOINETTE BAKER ARNP
Practice Location Address:

5208 NW 109TH WAY
CORAL SPRINGS, FL
33076-2748

Practice Phone: 954-599-2171
Practice Fax: 954-584-2274

1710849518 — MADELINE CARTER
Practice Location Address:

113 BO BO DR
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-4121
Practice Fax:

1881685220 — GLEN H STRIBLING OD
Practice Location Address:

110 E GEORGETOWN ST
CRYSTAL SPRINGS, MS
39059-2746

Practice Phone: 601-892-5053
Practice Fax: 601-892-5741

1558343889 — SPECIALTY MEDICAL SUPPLY OF MISSISSIPPI, INC.
Practice Location Address:

103A E GEORGETOWN ST
CRYSTAL SPRINGS, MS
39059-2777

Practice Phone: 601-892-0360
Practice Fax: 601-892-6055

Directions to “2083 THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.