Flint Creek Physical Therapy, LLC
Organization Active NPI Physical Therapy Clinic/Center · Wiggins, MS
NPI 1972028520 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1972028520
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- PT4487 (MS)
- Legal business name
- FLINT CREEK PHYSICAL THERAPY, LLC
- Practice address
- 321 Flora Gene Ave W Ste D
Wiggins, MS 39577-5008 - Phone
- (601) 523-1994
- Fax
- (601) 523-1995
- NPI assigned
- Aug 4, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Ryan H Harrell, DPT
- Title
- Physical Therapist/Owner
- Phone
- (601) 528-1994
Practitioners 3
-
James Ryan Ellis, PTA
-
Sable M Sanders, PTA
National Provider Directory
Locations
321 Flora Gene Ave W
Ste D
Wiggins, MS 39577
Phone (601) 523-1994
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PT4487 | MS | Yes |
Addresses
Primary practice location
321 Flora Gene Ave W Ste D
Wiggins, MS 39577-5008
Mailing address
321 Flora Gene Ave W Ste D
Wiggins, MS 39577-5008
Phone (601) 528-1994
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06070264 | Medicaid | MS |
Other providers in Wiggins, MS
- James Ryan Ellis
- Belinda Evans
- La'Toria Evans
- Teketra Evans
- Tori Fairley
- Hannah Leigh Fore
- Willimae Fulton
- William Bryan Gibboney
- Sharie Gilner
- Constance M Goodyear
All providers in Wiggins, 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 Jul 21, 2022. 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.