Grace Myofascial Clinic, Llc

LBN: Grace Myofascial Clinic, Llc
Grace Myofascial Clinic, Llc is an health care organization with primary practice located at 3000 Old Canton Rd Ste 240 , Jackson MS 39216-4235. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Grace Myofascial Clinic, Llc can be contacted via phone (601) 717-0910, or through Sellers, Amanda Weilenman via phone (601) 717-0910.

Contact Information

Primary practice address
3000 Old Canton Rd Ste 240 Jackson MS 39216-4235
Phone: (601) 717-0910
Fax: (769) 257-6382
Website:
Map and Directions
Authorized official contact:
Name: Sellers, Amanda Weilenman
Phone: (601) 717-0910

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X PT3632 Mississippi

Profile Details

NPI number 1457656639
LBN Legal business name Grace Myofascial Clinic, Llc
DBA Doing business as
Authorized official Sellers, Amanda Weilenman
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2011
Last updated Jul 17th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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