Individual
CHANDLER RIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 RESIDENTIAL CENTER RD, CHOCTAW, MS 39350-6780
(601) 389-2812
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6780
MS
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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