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Organization

COVENANT HEALTH & REHAB OF VICKSBURG, LLC

Active
Parent organization
COVENANT DOVE, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
COVENANT DOVE, LLC
Authorized official
CHRISTOPHER J MURPHY (VICE PRESIDENT)
(901) 937-7994
Entity
Organization

Contact information

Practice address
2850 PORTERS CHAPEL RD, VICKSBURG, MS 39180-1805
(601) 638-9211
(601) 636-4986
Mailing address
2850 PORTERS CHAPEL RD, VICKSBURG, MS 39180-1805
(601) 638-9211
(601) 636-4986

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
Primary
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01787098
MS
Enumeration date
12/08/2009
Last updated
04/12/2012
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