Craig S Bertelsen, PT, CERT MDT

Individual provider Active NPI Physical Therapist · Baldwyn, MS

NPI 1134319486 · NPPES record last updated Mar 8, 2013

Key facts

NPI
1134319486
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT2339 (MS)
Practice address
715 Highway 45
Baldwyn, MS 38824-8591
Phone
(662) 365-5610
Fax
(662) 365-5611
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Physical Therapy, Inc. Physical Therapist Past
since Dec 1, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2339 MS Yes

Addresses

Primary practice location

715 Highway 45
Baldwyn, MS 38824-8591

Mailing address

PO Box 366
715 Hwy 45
Baldwyn, MS 38824-0366
Phone (662) 365-5610

Other providers in Baldwyn, MS

All providers in Baldwyn, MS · Physical Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.