Organization
BAPTIST PT- LYMPHEDEMA CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRISSETT (BILLING MANAGER)
(601) 944-1717
Entity
Organization
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 974-6243
Mailing address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 974-6243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MS
Other
Enumeration date
12/03/2015
Last updated
12/04/2015
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