Organization
PRO PT
Active
Other names
Pro Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CORY LEE LPTA (OWNER)
(662) 231-0280
Entity
Organization
Contact information
Practice address
3077 HIGHWAY 371 N, MANTACHIE, MS 38855-7274
(662) 282-4949
(662) 282-4955
Mailing address
PO BOX 205, MANTACHIE, MS 38855-0205
(662) 282-4949
(662) 282-4955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08130311
—
MS
Enumeration date
03/15/2012
Last updated
06/27/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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