Organization
FLINT CREEK PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN H HARRELL DPT (PHYSICAL THERAPIST/OWNER)
(601) 528-1994
Entity
Organization
Contact information
Practice address
321 FLORA GENE AVE W STE D, WIGGINS, MS 39577-5008
(601) 523-1994
(601) 523-1995
Mailing address
321 FLORA GENE AVE W STE D, WIGGINS, MS 39577-5008
(601) 528-1994
(601) 528-1995
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT4487
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06070264
—
MS
Enumeration date
08/04/2017
Last updated
07/21/2022
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