Provider First Line Business Practice Location Address:
51 MAIN ST
Provider Second Line Business Practice Location Address:
ENCORE REHAB DEPT.
Provider Business Practice Location Address City Name:
PERKINSTON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39573-3374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-928-6362
Provider Business Practice Location Address Fax Number:
601-928-6299
Provider Enumeration Date:
02/18/2009