Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK DOUGLAS
Active Sole ProprietorJACK DOUGLAS is a Physical Therapy Assistant healthcare provider located in MONTICELLO, Mississippi. NPI 1508054404 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · MONTICELLO, MS
Registration Details
- NPI Number
- 1508054404
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 5, 2007 (18.82934238548 yrs)
- Last Updated
- Apr 7, 2010
- License
-
PT3353 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1065 E BROAD STMONTICELLO, MS, 396547703Browse MS providers · Browse ZIP 39654
- Phone
- 6015877115
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in MONTICELLO, MS
| Name | Credential | NPI |
|---|---|---|
| KIM LEWIS | — | 1316172505 |
| ARMANDA L. BOURNE | PT | 1760259212 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.