Organization
GPTRS II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY H TRUSSELL (DIRECTOR)
(601) 898-4324
Entity
Organization
Contact information
Practice address
128 BYRAM BUSINESS CENTER DR, BYRAM, MS 39272-9636
(601) 502-1194
Mailing address
128 BYRAM BUSINESS CENTER DR, BYRAM, MS 39272-9636
(601) 502-1194
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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