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Organization
GENESIS PHYSICAL THERAPY & REHABILITATION LLC
Active
Organization
GENESIS PHYSICAL THERAPY & REHABILITATION LLC
Active
Other names
Genesis Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARENCE WAYNE WHITLEY (C.O.O.)
(601) 898-7527
Entity
Organization
Contact information
Practice address
290 E LAYFAIR DR, SUITE B, FLOWOOD, MS 39232-9526
(601) 983-1200
(601) 983-1205
Mailing address
290 E LAYFAIR DR, SUITE B, FLOWOOD, MS 39232-9526
(601) 983-1200
(601) 983-1205
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
NULL
Other
Enumeration date
08/01/2006
Last updated
04/20/2008
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