Provider Demographics
NPI:1487911269
Name:MAXIMUM MOBILITY REHABILITATION & FITNESS INC
Entity type:Organization
Organization Name:MAXIMUM MOBILITY REHABILITATION & FITNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DUSTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:KYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-415-6099
Mailing Address - Street 1:125 PRATT DR
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-6040
Mailing Address - Country:US
Mailing Address - Phone:662-415-6099
Mailing Address - Fax:
Practice Address - Street 1:125 PRATT DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-6040
Practice Address - Country:US
Practice Address - Phone:662-415-6099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy