Individual provider · Type 1 NPI

R L. Conerly Jr., OT

Physical Therapy Assistant · Ridgeland, MS

NPI number 1174741557 Active

Practice location

711 Avignon Dr
Ridgeland, MS 39157-5120

Call (601) 605-6777 Map

Fax (800) 517-6935

Mailing address

PO Box 666
Columbia, MS 39429-0666

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XPTA2379 (MS)
Occupational Therapist 225X00000XOT1963 (MS)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1174741557

R L. Conerly Jr., OT's National Provider Identifier is 1174741557, issued on Apr 23, 2007. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Ridgeland, MS. The record was last updated on Sep 11, 2025.