# DYNAMIC REHABILITATION SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NEOLIFE PT AND WELLNESS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194102434
- **Authorized official:** DR. ROBERT RAY ELLIS DPT (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (228) 326-1115

## Contact information

- **Practice address:** 4016 CASSIMER AVE, DIBERVILLE, MS 39540-2309
- **Practice address phone:** (228) 280-8120
- **Mailing address:** 4016 CASSIMER AVE, DIBERVILLE, MS 39540-2309
- **Mailing address phone:** (228) 280-8120
- **Mailing address fax:** (228) 280-8121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT5070 | MS | Yes |

## Other

- **Enumeration date:** 05/06/2015
- **Last updated:** 07/05/2023