| Organization Name: | DYNAMIC REHABILITATION SERVICES LLC |
| NPI Number: | 1194102434 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT RAY ELLIS (PHYSICAL THERAPIST/OWNER) |
| Mailing Address: | 10470 Diberville Blvd Ste H Diberville |
| State: | MS US |
| Postal Code: | 395402419 |
| Phone Number: | 2283261115 |
| Fax Number: | |
| NPI Enumeration Date: | 05/06/2015 |
| NPI Last Update Date: | 07/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT5070 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |