Organization
JACKSON REHAB AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KIRTLEY (DIRECTOR)
(601) 316-8800
Entity
Organization
Contact information
Practice address
5380 I-55 N, SUITE 101, JACKSON, MS 39211
(601) 316-8800
(601) 899-5198
Mailing address
5380 I-55 N, SUITE 101, JACKSON, MS 39211
(601) 316-8800
(601) 899-5198
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02912
MEDICARE PART B
MS
Enumeration date
12/05/2006
Last updated
07/21/2022
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