Provider First Line Business Practice Location Address:
13 NORTHTOWN DRIVE UITE 110
Provider Second Line Business Practice Location Address:
TRINITY REHABILITATION, INC
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-206-9195
Provider Business Practice Location Address Fax Number:
601-957-8391
Provider Enumeration Date:
09/15/2009