GRACE MYOFASCIAL CLINIC, LLC – NPI #1457656639
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.

GRACE MYOFASCIAL CLINIC, LLC is an AHC clinic located in JACKSON, MS. NPPES has assigned the NPI number 1457656639 to GRACE MYOFASCIAL CLINIC, LLC on January 19, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Physical Therapy

The NPI profile was previously updated about 14 years ago on Jul 17, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRACE MYOFASCIAL CLINIC, LLC below.

NPI Profile for
GRACE MYOFASCIAL CLINIC, LLC

NPI Number
1457656639
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRACE MYOFASCIAL CLINIC, LLC
Primary location
3000 OLD CANTON RD STE 240
JACKSON, MS 39216-4235
Phone: (601) 717-0910 Fax: (769) 257-6382
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
AMANDA SELLERS
PHYSICAL THERAPIST
Phone: (601) 717-0910
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2000X
- Clinic/Center / Physical Therapy (Primary)
MS PT3632

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.