V A South

NPI 1821152877 - Physical Therapist - 225100000X

NPI Details
NPI 1821152877
Enumeration Date 12/21/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARCUS T MARCUS
Position OWNER
Phone (601) 636-6019
Fax (601) 661-8457
Practice Location
4304 HIGHWAY 80 W STE A
JACKSON MS, 39209-5922, US
Phone (601) 636-6019
Fax (601) 661-8457
Business Location
PO BOX 3183
RIDGELAND MS, 39158-3183, US
Phone (601) 636-6019
Fax (601) 661-8457
Toxanomy
Taxonomy Code 225100000X
License State Mississippi
License Number PT3192
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According to our database, V A South NPI is 1821152877, taxonomy code is 225100000X and license number is PT3192, license state is located at Mississippi. V A South physically located at 4304 Highway 80 W Ste A, Jackson MS, 39209-5922. NPI Number 1033115704 has the healthcare provider type.

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1821152877 NPI number is provided on an as is basis without warranty of any kind. 1821152877 is maintained by the National Plan & Provider Enumeration System. The contents of V A South are for informational purposes only.