Organization
BELHAVEN PHYSICAL THERAPY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BELCHER PT (PHYSICAL THERAPIST)
(601) 355-9624
Entity
Organization
Contact information
Practice address
1054 GREYMONT AVE, JACKSON, MS 39202-2718
(601) 355-9624
(601) 353-6151
Mailing address
1054 GREYMONT AVE, JACKSON, MS 39202-2718
(601) 355-9624
(601) 353-6151
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT2289
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT2289
PROVIDER NUMBER
MS
Enumeration date
05/04/2007
Last updated
08/22/2020
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