Provider Demographics
NPI:1427425149
Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Entity type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:276 NISSAN PKWY
Mailing Address - Street 2:BUILDING F, STE 400
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-7006
Mailing Address - Country:US
Mailing Address - Phone:601-859-3776
Mailing Address - Fax:601-859-3778
Practice Address - Street 1:276 NISSAN PKWY
Practice Address - Street 2:BUILDING F, STE 400
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-7006
Practice Address - Country:US
Practice Address - Phone:601-859-3776
Practice Address - Fax:601-859-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty