# BIOGENICS, LLC

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

## Provider details

- **NPI number:** 1821477167
- **Authorized official:** MR. SCOTT WAYNE GRANTHAM MPT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (601) 906-3718

## Contact information

- **Practice address:** 307 CHARTRESE DR, BRANDON, MS 39047-8779
- **Practice address phone:** (601) 906-3718
- **Mailing address:** 307 CHARTRESE DR, BRANDON, MS 39047-8779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | PT3612 | MS | Yes |

## Other

- **Enumeration date:** 05/19/2015
- **Last updated:** 05/19/2015