Organization
GENESIS HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BRADLEY WOODS LPTA (PHYSICAL THERAPY ASSISTANT)
(601) 278-8986
Entity
Organization
Contact information
Practice address
2142 E WHITWORTH ST, HAZLEHURST, MS 39083-9277
(601) 278-8986
Mailing address
2142 EAST WHITWORTH STREET, HAZLEHURST, MS 39083
(601) 278-8986
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4126
MS
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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