Provider Demographics
NPI:1962836742
Name:CLARKSDALE PHYSICAL THERAPY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CLARKSDALE PHYSICAL THERAPY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-261-9014
Mailing Address - Street 1:126 DESOTO AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-4420
Mailing Address - Country:US
Mailing Address - Phone:662-627-6734
Mailing Address - Fax:
Practice Address - Street 1:126 DESOTO AVE
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-4420
Practice Address - Country:US
Practice Address - Phone:662-627-6734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy