Individual
WAYNE P JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
464 CHURCH RD STE 400, MADISON, MS 39110-6940
(601) 650-0002
(601) 899-0088
Mailing address
921 W BEACON ST, PHILADELPHIA, MS 39350-3229
(601) 650-0002
(601) 650-9902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0331
MS
Other
Enumeration date
10/03/2006
Last updated
05/15/2019
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