Organization Name: | MEDICOMP, INC |
NPI Number: | 1346332574 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH MCNULTY (CEO) |
Mailing Address: | 7381 Siwell Rd Ste A Byram |
State: | MS US |
Postal Code: | 392728974 |
Phone Number: | 6013732075 |
Fax Number: | 6013732077 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 02/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | PT2964 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |