Provider Demographics
NPI:1285080044
Name:PHYSICAL THERAPY PLUS LLC
Entity type:Organization
Organization Name:PHYSICAL THERAPY PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:601-214-9186
Mailing Address - Street 1:118 CYPRESS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-7658
Mailing Address - Country:US
Mailing Address - Phone:601-214-9186
Mailing Address - Fax:601-898-3699
Practice Address - Street 1:118 CYPRESS RIDGE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-7658
Practice Address - Country:US
Practice Address - Phone:601-214-9186
Practice Address - Fax:601-898-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty