Organization
HATTIESBURG CLINIC PA
Active
Other names
Purvis Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON MD (EXECUTIVE DIRECTOR)
(601) 268-5601
Entity
Organization
Contact information
Practice address
98 SHELBY SPEIGHTS DR, PURVIS, MS 39475-4528
(601) 794-2402
(601) 794-2404
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09656801
—
MS
Enumeration date
10/06/2006
Last updated
10/07/2020
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