Organization
THERAPYWORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANNON LANE BROWN COTA (OWNER)
(601) 467-3476
Entity
Organization
Contact information
Practice address
5 BRIANLEIGH DR, LAUREL, MS 39443-5798
(601) 467-3476
Mailing address
PO BOX 4252, LAUREL, MS 39441-4252
(601) 467-3476
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
TA2354
MS
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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