| Organization Name: | NEW LIFE PHYSICAL THERAPY CENTER LLC |
| NPI Number: | 1952339491 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WANDA ABRON (SENIOR ADMINISTRATOR) |
| Mailing Address: | 4832 Plaza Dr Tylertown |
| State: | MS US |
| Postal Code: | 396679221 |
| Phone Number: | 6018764429 |
| Fax Number: | 6018764422 |
| NPI Enumeration Date: | 06/30/2006 |
| NPI Last Update Date: | 01/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 35833481K |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |