Revive Pelvic Health & Physical Therapy Llc | |
107 Victoria Ln Clinton MS 39056-4031 | |
(601) 953-6876 | |
Not Available |
Full Name | Revive Pelvic Health & Physical Therapy Llc |
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Speciality | Clinic/Center |
Location | 107 Victoria Ln, Clinton, Mississippi |
Authorized Official Name and Position | Veronica Barton (CEO) |
Authorized Official Contact | 6019536876 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Revive Pelvic Health & Physical Therapy Llc 107 Victoria Ln Clinton MS 39056-4031 Ph: (601) 953-6876 | Revive Pelvic Health & Physical Therapy Llc 107 Victoria Ln Clinton MS 39056-4031 Ph: (601) 953-6876 |
NPI Number | 1689266009 |
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Provider Enumeration Date | 02/08/2021 |
Last Update Date | 02/08/2021 |
Medicare PECOS PAC ID | 3375925365 |
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Medicare Enrollment ID | O20220808002832 |
Identifier | Type | State | Issuer |
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1689266009 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Veronica Woodson |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1508346222 PECOS PAC ID: 0547642530 Enrollment ID: I20220808002862 |
Clinton Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Highway 80 E, Suite D, Clinton, MS 39056 Phone: 318-791-3765 Fax: 877-747-5326 | |
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