Organization
JACKSON HAND AND UPPER EXTREMITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN ROBERTS PT (OWNER)
(601) 942-2709
Entity
Organization
Contact information
Practice address
1904 LAKELAND DR, SUITE D, JACKSON, MS 39216-5038
(601) 942-2709
(601) 944-9780
Mailing address
1904 LAKELAND DR, SUITE D, JACKSON, MS 39216-5038
(601) 942-2709
(601) 944-9780
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT0987
MS
225XH1200X
Hand Occupational Therapist
Primary
45OT073
MS
Other
Enumeration date
08/02/2013
Last updated
07/08/2014
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