Provider Demographics
NPI:1023280468
Name:TRI THERAPY PLLC
Entity type:Organization
Organization Name:TRI THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:601-833-7317
Mailing Address - Street 1:335 E BAY ST
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:MS
Mailing Address - Zip Code:39652-2815
Mailing Address - Country:US
Mailing Address - Phone:601-783-0220
Mailing Address - Fax:601-783-0222
Practice Address - Street 1:335 E BAY ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:MS
Practice Address - Zip Code:39652-2815
Practice Address - Country:US
Practice Address - Phone:601-783-0220
Practice Address - Fax:601-783-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05686296Medicaid
MS468509Medicare PIN