Organization
GRENADA PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EDWARD HILL II P.T. (OWNER)
(662) 227-9748
Entity
Organization
Contact information
Practice address
601 OLD HICKORY RD, STE A, GRENADA, MS 38901-4086
(662) 227-9748
(662) 227-9769
Mailing address
PO BOX 278, GRENADA, MS 38902-0278
(662) 227-9748
(662) 227-9769
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT2219
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016043
—
MS
Enumeration date
10/06/2006
Last updated
04/25/2019
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