# TEAM 82 PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154626497
- **Authorized official:** MR. JIMMY LEE SMITH II (MANAGING MEMBER)
- **Authorized official phone:** (601) 497-1200

## Contact information

- **Practice address:** 1198 LAKELAND DR, JACKSON, MS 39216-4701
- **Practice address phone:** (601) 951-9760
- **Mailing address:** PO BOX 16153, JACKSON, MS 39236-6153
- **Mailing address phone:** (601) 951-9760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2011
- **Last updated:** 01/18/2011