OrganizationActive
Abc Pediatric Therapy of Mississippi, LLC
NPI 1821778713 · Physical Therapy Clinic/Center · Southaven, MS
Provider details
- NPI number
- 1821778713
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jessica Whalum, Occupational Therapist(662) 536-6884
Specialties & taxonomies
Ambulatory Health Care Facilities
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
- Rehabilitation Clinic/Center261QR0400X
Ambulatory Health Care Facilities
Practice location
1130 Stateline Rd E Ste D-E
Southaven, MS 38671-8700
Phone: (662) 536-6884
Fax: (662) 510-5892
Approximate (ZIP-level) locationGet directions
Mailing address
1130 Stateline Rd E Ste D-E
Southaven, MS 38671-8700
Registry dates
- Enumerated
- 2023-07-24
- Last updated
- 2024-01-30
- Certified
- 2024-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.