| Organization Name: | TRAIL BLAZIN THERAPY LLC |
| NPI Number: | 1336367135 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RACHELLE BENTON (OWNER,MANAGER) |
| Mailing Address: | 260 Barnes Rd Florence |
| State: | MS US |
| Postal Code: | 390738066 |
| Phone Number: | 6018450876 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | P.T.0978 |
| 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 |