Organization
MID-SOUTH PHYSICAL THERAPY, INC.
Active
Organization
MID-SOUTH PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALVIN DEWAYNE CARTER (ADMINISTRATOR)
(901) 837-1711
Entity
Organization
Contact information
Practice address
340 ATOKA MCLAUGHLIN DR STE B, ATOKA, TN 38004-4825
(901) 837-1711
(901) 837-1232
Mailing address
340 ATOKA MCLAUGHLIN DR STE B, ATOKA, TN 38004-4825
(901) 837-1711
(901) 837-1232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2580
TN
225100000X
Physical Therapist
569
TN
225100000X
Physical Therapist
Primary
7559
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3646013
—
TN
05
—
3651450
—
TN
Enumeration date
10/12/2006
Last updated
08/02/2023
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