Organization · Type 2 NPI

Physical Therapy Occupational Therapy Speech Therapy

Physical Therapist · Vicksburg, MS

NPI number 1922838994 Active

Practice location

3419 Wisconsin Ave
Vicksburg, MS 39180-5330

Mailing address

321 Poppyseed Ln
Raymond, MS 39154-2100

Specialties and licenses

TaxonomyCodeLicense
Physical Therapist Primary 225100000XNone listed

Physical Therapist: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, r…

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About NPI 1922838994

Physical Therapy Occupational Therapy Speech Therapy's National Provider Identifier is 1922838994, issued on Aug 5, 2024. The primary taxonomy on file is Physical Therapist (225100000X), and the practice location is in Vicksburg, MS. The record was last updated on Dec 3, 2025.