Organization
BAPTIST PT - JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRISSETT (BILLING MANAGER)
(601) 944-1717
Entity
Organization
Contact information
Practice address
1190 N STATE ST, JACKSON, MS 39202-2413
(601) 968-1148
(601) 968-1337
Mailing address
1190 N STATE ST, JACKSON, MS 39202-2413
(601) 968-1148
(601) 968-1337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/11/2011
Last updated
12/04/2015
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