Church, Joseph Albert

Church, Joseph Albert is an individual health care provider with primary practice located at 1105 39Th Ave , Gulfport MS 39501-2654. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, which is considered as his primary health care specialty. Church, Joseph Albert can be contacted via phone (228) 575-4654.

Contact Information

Primary practice address
1105 39Th Ave Gulfport MS 39501-2654
Phone: (228) 575-4654
Fax: (228) 575-4651
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand 225XH1200X OT0116 Mississippi

Profile Details

NPI number 1265470744
LBN Legal business name Church, Joseph Albert
Credentials OTR/L-CHT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Jan 29th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265470744 NPPES
Mississippi MEDICAID 00119593

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