Trail Blazin Therapy LLC
Organization Active NPI Physical Therapist · Florence, MS
NPI 1336367135 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1336367135
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- P.T.0978 (MS)
- Legal business name
- TRAIL BLAZIN THERAPY LLC
- Practice address
- 260 Barnes Rd
Florence, MS 39073-8066 - Phone
- (601) 845-0876
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Rachelle Benton, P.T.
- Title
- Owner,Manager
- Phone
- (601) 845-0876
Practitioners 1
-
Regina Ann Scott, OTRL
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | P.T.0978 | MS | Yes |
Addresses
Primary practice location
260 Barnes Rd
Florence, MS 39073-8066
Mailing address
260 Barnes Rd
Florence, MS 39073-8066
Phone (601) 845-0876
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09016256 | Medicaid | MS |
Other providers in Florence, MS
- April Melanie Sylvia
- The Sleep Lab, LLC
- Karla Joy Thompson
- Jessalynn Denton Thurman
- Total Rehab, Inc
- Mary Danielle Traylor
- Thomas Tubby
- Hunter R Tyler
- Eletha Walker
- Imani Me'Shel Webb
All providers in Florence, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.