Individual
MS. CAROLINE GORDY FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
13010 HWY 18, RAYMOND, MS 39154-9526
(601) 857-2229
(601) 857-8223
Mailing address
921 WEST BEACON STREET, PHILADELPHIA, MS 39350
(601) 650-0002
(601) 650-9902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7134
MS
Other
Enumeration date
08/23/2021
Last updated
10/30/2023
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