Functional Therapy LLC
NPI #1417235490 in Picayune, Mississippi
Provider Information
- NPI Number
- 1417235490
- Entity Type
- Organization
- Organization Name
- Functional Therapy LLC
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- Jul 25, 2011
- Last Updated
- Dec 31, 2014
Practice Location
- Address
- 311 N MAIN ST
- City
- Picayune
- State
- Mississippi
- ZIP Code
- 39466-3313
- Phone
- (601) 799-4065
Authorized Official
- Name
- STACEY S VOLLENWEIDER, OTR/L
- Title
- OWNER
- Phone
- (228) 216-9996
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
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