Organization
PRO HEALTH AQUISITION COMPANY
Active
Other names
Cornerstone Rehabilitation of Kosciusko
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS L WINDHAM (SECRETARY/ TREASURER)
(662) 473-3400
Entity
Organization
Contact information
Practice address
140 N WELLS ST, KOSCIUSKO, MS 39090-3637
(662) 290-6020
(662) 290-6070
Mailing address
50 S MAIN ST, WATER VALLEY, MS 38965-2946
(662) 473-3400
(662) 473-4389
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04409521
—
MS
Enumeration date
06/18/2006
Last updated
08/22/2020
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