Organization
RECONNECT THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH KAVANAGH PT (PRESIDENT)
(251) 605-4669
Entity
Organization
Contact information
Practice address
1410 W QUITMAN ST, IUKA, MS 38852-1129
(662) 423-3422
(662) 423-5259
Mailing address
1410 W QUITMAN ST, IUKA, MS 38852-1129
(662) 423-3422
(662) 423-5259
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
12072634
MS
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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