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Organization

CHILDREN'S REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KAREN E. ROBERSON RPT (OWNER/PHYSICAL THERAPIST)
(662) 418-0233
Entity
Organization

Contact information

Practice address
501 HIGHWAY 12 W STE 150E, STARKVILLE, MS 39759-3643
(662) 418-0233
(662) 338-5439
Mailing address
1108 DR MARTIN LUTHER KING JR DR W, STARKVILLE, MS 39759-8864
(662) 418-0233
(662) 338-5439

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 1706
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00123291
MS
Enumeration date
12/29/2009
Last updated
12/29/2009
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