Provider Demographics
NPI:1245686575
Name:SYNERGY PHYSICAL THERAPY & SPORTS MEDICINE, LLC
Entity type:Organization
Organization Name:SYNERGY PHYSICAL THERAPY & SPORTS MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT,ATC
Authorized Official - Phone:601-917-5440
Mailing Address - Street 1:2447 47TH COURT
Mailing Address - Street 2:SUITE F
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305
Mailing Address - Country:US
Mailing Address - Phone:601-917-5440
Mailing Address - Fax:
Practice Address - Street 1:2447 47TH COURT
Practice Address - Street 2:SUITE F
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305
Practice Address - Country:US
Practice Address - Phone:601-917-5440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3062261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy