Organization
COLLINSVILLE PHYSICAL THERAPY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEWAYNA LEA ROBERTS (OFFICW MANAGER)
(601) 626-8885
Entity
Organization
Contact information
Practice address
9099 COLLINSVILLE RD # A, COLLINSVILLE, MS 39325-9779
(601) 626-8885
(601) 626-8885
Mailing address
9099 COLLINSVILLE RD # A, COLLINSVILLE, MS 39325-9779
(601) 626-8885
(601) 626-8885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3002
MS
Other
Enumeration date
06/18/2007
Last updated
11/01/2010
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