Provider Demographics
NPI:1548608060
Name:GPTRS II
Entity Type:Organization
Organization Name:GPTRS II
Other - Org Name:GENESIS PHYSICAL THERAPY AND REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-898-7530
Mailing Address - Street 1:214 PARKWAY EAST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:308 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8803
Practice Address - Country:US
Practice Address - Phone:601-898-7527
Practice Address - Fax:601-898-7577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty