Petrides, John S

Petrides, John S is an individual health care provider with primary practice located at 5699 Getwell Rd Building E, Suite 2, Southaven MS 38672-7312. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Petrides, John S can be contacted via phone (662) 349-6712.

Contact Information

Primary practice address
5699 Getwell Rd Building E, Suite 2 Southaven MS 38672-7312
Phone: (662) 349-6712
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT3548 Mississippi

Profile Details

NPI number 1982923652
LBN Legal business name Petrides, John S
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2010
Last updated May 20th, 2010 - about 15 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 1982923652 NPPES
Mississippi Other PT3548 PT LICENSE: MISSISSIPPI

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