Organization
CUSTOMIZED PHYSICAL THERAPY
Active
Organization
CUSTOMIZED PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA M RIMES P.T. (OWNER)
(601) 408-8700
Entity
Organization
Contact information
Practice address
103 FOX CHASE DR, HATTIESBURG, MS 39402-2575
(601) 408-8700
(601) 264-2285
Mailing address
702 HILLENDALE DR, HATTIESBURG, MS 39402-2618
(601) 408-8700
(601) 264-2285
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 1137
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 1137
PHYSICAL THERAPY
MS
Enumeration date
01/04/2007
Last updated
08/22/2020
Update your record
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