Organization
TOTAL REHAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT WAYNE GRANTHAM PT (PHYSICAL THERAPIST/OWNER)
(601) 906-3718
Entity
Organization
Contact information
Practice address
307 CHARTRESE DR, BRANDON, MS 39047-8779
(601) 906-3718
Mailing address
307 CHARTRESE DR, BRANDON, MS 39047-8779
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
PT3612
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09504253
—
MS
Enumeration date
07/23/2013
Last updated
07/26/2016
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