Individual
ELIZABETH KAVANAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
176 HWY 9 NORTH, BRUCE, MS 38915
(662) 412-5220
Mailing address
2844 TRACELAND DR, TUPELO, MS 38801-4200
(662) 680-3148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1225
MS
225100000X
Physical Therapist
PT22065
FL
225100000X
Physical Therapist
PTH1467
AL
Other
Enumeration date
07/30/2010
Last updated
07/30/2010
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