NPI 1811292501

Mark Leslie Grogan

Practitioner Physical Therapy Assistant Madison, MS

Practice location

Address: 401 Baptist Dr Suite 306, Madison, MS 39110-2009
Phone: (601) 607-7204
Fax: (601) 607-7430

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA4334 (MS)

Other Physical Therapy Assistant providers in Mississippi →

Registry record

NPI: 1811292501
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jan 2011
Record last updated: 11 Jan 2011

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.