# PROACTIVE PHYSICAL THERAPY LLC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1538969795
- **Authorized official:** DR. KENDRIQUE AKEEM MORGAN DPT (OWNER)
- **Authorized official phone:** (601) 218-5004

## Contact information

- **Practice address:** 701 ANTHONY ST, PORT GIBSON, MS 39150-2053
- **Practice address phone:** (601) 218-5004
- **Mailing address:** 701 ANTHONY ST, PORT GIBSON, MS 39150-2053
- **Mailing address phone:** (601) 994-3548
- **Mailing address fax:** (601) 448-0234

## Taxonomy

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

## Other

- **Enumeration date:** 03/17/2025
- **Last updated:** 01/05/2026