| Revolution Physical Therapy Llc | |
|
3075 Goodman Rd E Suite 7, Southaven, MS 38672-6359 | |
| (662) 349-9288 | |
| (662) 349-9289 |
| Full Name | Revolution Physical Therapy Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 3075 Goodman Rd E Suite 7, Southaven, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518469063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Amy R Graham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467410969 PECOS PAC ID: 8729062971 Enrollment ID: I20060906000526 |
| Mailing Address | Practice Location Address |
|---|---|
| Revolution Physical Therapy Llc 3075 Goodman Rd E Suite 7, Southaven, MS 38672-6359 Ph: (662) 349-9288 | Revolution Physical Therapy Llc 3075 Goodman Rd E Suite 7, Southaven, MS 38672-6359 Ph: (662) 349-9288 |
Parker P Haberstroh, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1100 Church Rd W Ste 112, Southaven, MS 38671 Phone: 662-548-3650 Fax: 662-654-8029 | |
Michael Newton Phillips, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3451 Goodman Rd E Ste 108, Southaven, MS 38672 Phone: 662-890-6953 | |
Mrs. Deborah Jill Patton, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5271 Getwell Rd, Southaven, MS 38672 Phone: 662-510-5694 | |
Mrs. Tara Elaine Burt, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 Phone: 662-536-4096 Fax: 662-536-4099 | |
Ms. Jerrica Thomas, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7545 Airways Blvd, Southaven, MS 38671 Phone: 901-759-3208 | |
Lacey Moody, Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 3964 Goodman Rd E, Suite 111, Southaven, MS 38672 Phone: 662-890-6953 Fax: 662-890-6954 | |
Mrs. Jennifer Dixon Brown, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 7545 Airways Blvd, Southaven, MS 38671 Phone: 901-759-3208 Fax: 901-759-3216 |