Organization
CAPITOL PHYSICAL THERAPY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BENFORD P.T. (PRESIDENT)
(601) 978-1798
Entity
Organization
Contact information
Practice address
2648 RIDGEWOOD RD, SUITE A, JACKSON, MS 39216-4903
(601) 366-1456
(601) 366-1448
Mailing address
5888 RIDGEWOOD RD STE B, JACKSON, MS 39211-2644
(601) 978-1798
(601) 978-1799
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0223
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05855578
—
MS
Enumeration date
05/23/2007
Last updated
03/17/2023
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