| Organization Name: | MISSISSIPPI STATE UNIVERSITY |
| NPI Number: | 1659643179 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANIE CIRLOT-NEW (DIRECTOR) |
| Mailing Address: | 326 Hardy Road Mississippi State |
| State: | MS US |
| Postal Code: | 397629736 |
| Phone Number: | 6623251028 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2012 |
| NPI Last Update Date: | 01/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | OT2147 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |