Organization
NEW LIFE PHYSICAL THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA ABRON (SENIOR ADMINISTRATOR)
(601) 876-4429
Entity
Organization
Contact information
Practice address
4832 PLAZA DR, TYLERTOWN, MS 39667-9221
(601) 876-4429
(601) 876-4422
Mailing address
4832 PLAZA DR, TYLERTOWN, MS 39667-9221
(601) 876-4429
(601) 876-4422
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
35833481K
LA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5745260001
LA
Other
Enumeration date
06/30/2006
Last updated
01/12/2009
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