Organization
GRASSROOTS THERAPY SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MIMMS MOTR/L (OWNER)
(662) 497-0485
Entity
Organization
Contact information
Practice address
1057 MONROE ST, JACKSON, MS 39202-2730
(662) 497-0485
Mailing address
1057 MONROE ST, JACKSON, MS 39202-2730
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2925
MS
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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