Organization
2083 THERAPY, LLC
Active
Other names
2083 Therapy of Crystal Springs
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MCNULTY IV (CEO)
(601) 849-6440
Entity
Organization
Contact information
Practice address
513 W MARION AVE, CRYSTAL SPRINGS, MS 39059-2748
(601) 281-5930
Mailing address
110 PIONEER WAY, MAGEE, MS 39111-5501
(601) 849-6440
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1109164
BUSINESS LICENSE
MS
Enumeration date
09/25/2017
Last updated
09/25/2017
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