Provider Demographics
NPI:1598043309
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:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-898-4324
Mailing Address - Street 1:106 HIGHLAND WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6929
Mailing Address - Country:US
Mailing Address - Phone:601-790-9446
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:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty