Organization
PEARL RIVER REHAB, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD H. RAMBERG (BUSINESS MANAGER)
(601) 798-8003
Entity
Organization
Contact information
Practice address
1000 FIFTH AVE, PICAYUNE, MS 39466-3214
(601) 798-8003
(601) 798-6050
Mailing address
1000 FIFTH AVE, PICAYUNE, MS 39466-3214
(601) 798-8003
(601) 798-6050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015114
—
MS
Enumeration date
08/03/2006
Last updated
08/22/2020
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