Individual
MR. JUSTIN KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
206 BAY AVE, RICHTON, MS 39476-2941
(601) 788-6316
Mailing address
128 JACKSON AVE, PETAL, MS 39465-2330
(601) 562-6681
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA5124
MS
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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