Organization
MEDICOMP, INC.
Active
Other names
Forest Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH S MCNULTY III (CEO)
(601) 849-6440
Entity
Organization
Contact information
Practice address
813 W THIRD ST, FOREST, MS 39074-4006
(601) 469-1001
(601) 469-1009
Mailing address
813 W THIRD ST, FOREST, MS 39074-4006
(601) 469-1001
(601) 469-1009
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04903263
—
MS
Enumeration date
11/24/2010
Last updated
11/24/2010
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