NPI 1104630144

Active Life Physical Therapy

Organisation Physical Therapy Clinic/Center Madison, MS

Practice location

Address: 106 Camden Trl, Madison, MS 39110-6601
Phone: (985) 630-7912

Authorised official

Name: Jeremy Ray Kennedy
Title: Physical Therapist
Phone: (985) 630-7912

Registered specialties

Physical Therapy Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2000X

Other Clinic/Center providers in Mississippi →

Registry record

NPI: 1104630144
Entity type: Organization
NPI issued: 1 Feb 2025
Record last updated: 1 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.