Organization
A FOCUSED BRAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN POE (OFFICE MANAGER)
(601) 427-5775
Entity
Organization
Contact information
Practice address
7712 OLD CANTON RD, MADISON, MS 39110-9299
(601) 427-5775
Mailing address
4345 MEADOWRIDGE DR, JACKSON, MS 39206-5912
(601) 259-6917
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OT2806
MS
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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