Melissa Hardin Crockett, LPTA

Individual provider Active NPI Physical Therapy Assistant · Saltillo, MS

NPI 1003197922 · NPPES record last updated Sep 6, 2011

Key facts

NPI
1003197922
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA1363 (MS)
Practice address
115 Park Ridge Rd
Saltillo, MS 38866-9390
Phone
(662) 687-2886
NPI assigned
Sep 6, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA1363MSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1363 MS Yes

Addresses

Primary practice location

115 Park Ridge Rd
Saltillo, MS 38866-9390

Mailing address

115 Park Ridge Rd
Saltillo, MS 38866-9390
Phone (662) 687-2886

Other providers in Saltillo, MS

All providers in Saltillo, MS · Physical Therapy Assistant in Mississippi

Sources for this page

Verify at the official NPI Registry.