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Wallace Cresswell, P.T
NPI 1740574532 · on the registry since 2011 · sole proprietor
Practice
- Address
- 1855 Hill Dr
Grenada, MS 38901 - Phone
- (662) 809-3339
- Organisation at this address
- Providence Pcc Of Grenada, Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-06-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi