Rachell Bateman

Individual provider Active NPI Physical Therapy Assistant · Brandon, MS

NPI 1699196352 · NPPES record last updated Dec 26, 2013

Key facts

NPI
1699196352
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA 3658 (MS)
Practice address
140 Eagle Dr
Brandon, MS 39047-7775
Phone
(601) 480-4848
NPI assigned
Dec 26, 2013
Sex
Female
Sole proprietor
No

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
PTA 3658MSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 3658 MS Yes

Addresses

Primary practice location

140 Eagle Dr
Brandon, MS 39047-7775

Mailing address

140 Eagle Dr
Brandon, MS 39047

Other providers in Brandon, MS

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

Sources for this page

Verify at the official NPI Registry.