# DRAYER PHYSICAL THERAPY JACKSON LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Performance Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780054072
- **Authorized official:** ERIC J WILLIAMS (PRESIDENT AND CEO)
- **Authorized official phone:** (717) 220-2100

## Contact information

- **Practice address:** 1201 HIGHWAY 49 S, SUITE 2, RICHLAND, MS 39218-9425
- **Practice address phone:** (769) 233-8844
- **Practice address fax:** (769) 251-1825
- **Mailing address:** 1201 HIGHWAY 49 S, SUITE 2, RICHLAND, MS 39218-9425
- **Mailing address phone:** (769) 233-8844
- **Mailing address fax:** (769) 251-1825

## Taxonomy

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

## Other

- **Enumeration date:** 09/30/2015
- **Last updated:** 09/30/2015