Sporty Sprouts INC
NPI #1780978502 in Brandon, Mississippi
Provider Information
- NPI Number
- 1780978502
- Entity Type
- Organization
- Organization Name
- Sporty Sprouts INC
- Primary Specialty
- Physical Therapist - Pediatrics
- Enumeration Date
- Jun 9, 2011
- Last Updated
- Jun 9, 2011
Practice Location
- Address
- 104 FAITH WAY
- City
- Brandon
- State
- Mississippi
- ZIP Code
- 39042-8676
- Phone
- (601) 850-3698
Authorized Official
- Name
- MR. BRANDON EUGENE HOLMES
- Title
- CEO
- Phone
- (601) 850-3698
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist - Pediatrics — Pediatrics |
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