Provider Demographics
NPI:1033396486
Name:PHYSICAL REHABILITATION MANAGEMENT
Entity Type:Organization
Organization Name:PHYSICAL REHABILITATION MANAGEMENT
Other - Org Name:RICHLAND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-420-5838
Mailing Address - Street 1:655 HIGHWAY 49 S
Mailing Address - Street 2:SUITE K
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218-8419
Mailing Address - Country:US
Mailing Address - Phone:601-420-5838
Mailing Address - Fax:601-420-5839
Practice Address - Street 1:655 HIGHWAY 49 S
Practice Address - Street 2:SUITE K
Practice Address - City:RICHLAND
Practice Address - State:MS
Practice Address - Zip Code:39218-8419
Practice Address - Country:US
Practice Address - Phone:601-420-5838
Practice Address - Fax:601-420-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty