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Organization
CLARKSDALE PHYSICAL THERAPY INC
Active
Organization
CLARKSDALE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS L WINDHAM (SECRETARY/ TREASURER)
(662) 473-3400
Entity
Organization
Contact information
Practice address
100 EAST LEE, CLARKSDALE, MS 38614
(662) 627-6734
(662) 627-6737
Mailing address
50 S MAIN ST, WATER VALLEY, MS 38965-2946
(662) 473-3400
(662) 473-4389
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015818
—
MS
Enumeration date
06/27/2006
Last updated
12/02/2010
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