Organization
ADVANCE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS RYAN SHORT P.T. (VICE PRESIDENT)
(662) 843-4990
Entity
Organization
Contact information
Practice address
810 E SUNFLOWER RD, SUITE 150, CLEVELAND, MS 38732
(662) 843-4990
(662) 843-4954
Mailing address
810 E SUNFLOWER RD, SUITE 150, CLEVELAND, MS 38732
(662) 843-4990
(662) 843-4954
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09385726
—
MS
Enumeration date
10/04/2006
Last updated
05/30/2008
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