Provider Demographics
NPI:1386190056
Name:PEARSON, SVEN (MS, ATC, LAT, CAMCP)
Entity Type:Individual
Prefix:MR
First Name:SVEN
Middle Name:
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MS, ATC, LAT, CAMCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 COLLEGE DR # 5017
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39406-0002
Mailing Address - Country:US
Mailing Address - Phone:601-447-4088
Mailing Address - Fax:601-266-6821
Practice Address - Street 1:118 COLLEGE DR # 5017
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39406-0002
Practice Address - Country:US
Practice Address - Phone:601-447-4088
Practice Address - Fax:601-266-6821
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer