Organization
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.
Active
Other names
Jackson-Hinds Comprehensive Health Center - Physical Therapy, Gary Road Elementary
Organization subpart
No
Provider details
NPI number
Authorized official
JASMIN CHAPMAN DDS (CHIEF EXECUTIVE OFFICER)
(601) 364-5142
Entity
Organization
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MS
Enumeration date
06/13/2017
Last updated
12/22/2017
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