Provider Demographics
NPI:1437986742
Name:ACCESSIBLE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ACCESSIBLE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WINDHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:406-253-9498
Mailing Address - Street 1:4780 I 55 N STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5583
Mailing Address - Country:US
Mailing Address - Phone:662-714-3122
Mailing Address - Fax:662-714-3124
Practice Address - Street 1:5140 GALAXIE DR STE 106
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-4354
Practice Address - Country:US
Practice Address - Phone:662-714-3122
Practice Address - Fax:662-714-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty