Organization
PHYSICAL THERAPY PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDIE LEON TINGLE JR. MSPT (OWNER/DIRECTOR)
(228) 769-0112
Entity
Organization
Contact information
Practice address
926 JACKSON AVE, PASCAGOULA, MS 39567
(228) 769-0112
(228) 769-0199
Mailing address
P.O. BOX 1661, PASCAGOULA, MS 39567-1661
(228) 769-0112
(228) 769-0199
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3068
MS
261QP2000X
Physical Therapy Clinic/Center
—
MS
Other
Enumeration date
08/04/2010
Last updated
11/10/2014
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