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Fundamental Therapy Llc
Specialist in Picayune, Mississippi
NPI 1659796860

Fundamental Therapy Llc is a Specialist based in Picayune, MS. Fundamental Therapy Llc practices in Picayune, MS. The NPI Number for Fundamental Therapy Llc is 1659796860 and holds a License No. OT2316 (Mississippi).

The current practice location address for Fundamental Therapy Llc is 311 N Main St, Picayune, MS and can be reached out via phone at 601-799-4065 and via fax at 601-620-4117.

Location: 311 N Main St, Picayune, MS, 39466-9224
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1659796860
Provider Name
Fundamental Therapy Llc
Credential
Provider Entity Type
Organization
Address
311 N Main St, Picayune, MS, 39466-9224
Phone Number
601-799-4065
Fax Number
601-620-4117
Provider Enumeration Date
02/25/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
05587048 05 MS
institution
Provider Business Practice Location Address Details
Address
311 N Main St
City
Picayune
State
Mississippi
Zip
39466-3313
Phone Number
601-799-4065
Fax Number
601-620-4117
person
Provider Business Mailing Address Details
Address
311 N Main St
City
Picayune
State
Mississippi
Zip
39466-3313
Phone Number
601-799-4065
Fax Number
601-620-4117
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
OT2316 (Mississippi)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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