Organization
TEAM 82 PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY LEE SMITH II (MANAGING MEMBER)
(601) 497-1200
Entity
Organization
Contact information
Practice address
1198 LAKELAND DR, JACKSON, MS 39216-4701
(601) 951-9760
Mailing address
PO BOX 16153, JACKSON, MS 39236-6153
(601) 951-9760
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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