NPI 1003900697

Wayne P Jimenez, PT

Practitioner Physical Therapist Madison, MS

Practice location

Address: 464 Church Rd STE 400, Madison, MS 39110-6940
Phone: (601) 650-0002
Fax: (601) 899-0088
Mailing address: 921 W Beacon St, Philadelphia, MS 39350-3229

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PT0331 (MS)

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Registry record

NPI: 1003900697
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Oct 2006
Record last updated: 15 May 2019

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.