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Organization

SIMPLE STROKES THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROBIN P SMITH MPT (OWNER/CLINICAL DIRECTOR)
(662) 349-8787
Entity
Organization

Contact information

Practice address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
(662) 349-8787
(662) 349-8757
Mailing address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
(662) 349-8787
(662) 349-8757

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0783311.1
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017154659
SALES TAX PERMIT
MS
01
0783311.1
DME
MS
Enumeration date
08/04/2008
Last updated
08/04/2008
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