Organization
MID SOUTH REHAB OUTPATIENT CLINIC LLC
Active
Other names
360 Total Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLEAN RANSOM WILLIAMS OTR/L, CHC (VP OF COMPLIANCE/HIM)
(601) 909-4210
Entity
Organization
Contact information
Practice address
3131 N HIGHLAND AVE, JACKSON, TN 38305-3418
(601) 605-6777
(601) 607-1415
Mailing address
599C STEED RD, RIDGELAND, MS 39157-1707
(601) 605-6777
(601) 607-1415
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
TN
Other
Enumeration date
01/05/2017
Last updated
06/20/2024
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