Active Life Physical Therapy
Organization Active NPI Physical Therapy Clinic/Center · Madison, MS
NPI 1104630144 · NPPES record last updated Feb 1, 2025
Key facts
- NPI
- 1104630144
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- ACTIVE LIFE PHYSICAL THERAPY
- Practice address
- 106 Camden TRL
Madison, MS 39110-6601 - Phone
- (985) 630-7912
- NPI assigned
- Feb 1, 2025
- Organization subpart
- No
Authorized official
- Name
- Jeremy Ray Kennedy, PT, DPT
- Title
- Physical Therapist
- Phone
- (985) 630-7912
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
106 Camden TRL
Madison, MS 39110-6601
Mailing address
106 Camden TRL
Madison, MS 39110-6601
Other providers in Madison, MS
- 2083 Therapy, LLC
- A Focused Brain LLC
- Acorn Counseling LLC
- Clifford C Adams III
- Advanced Interventional Specialist PLLC
- Christy Ainsworth
- Connor Hays Ainsworth
- Heston Neal Ainsworth
All providers in Madison, MS · Physical Therapy Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.