Madison Bosarge, PTA
Individual provider Active NPI Physical Therapy Assistant · Saucier, MS
NPI 1760113468 · NPPES record last updated Jun 22, 2022
Key facts
- NPI
- 1760113468
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA6756 (MS)
- Practice address
- 11320 Hood Rd
Saucier, MS 39574-8272 - Phone
- (228) 697-9931
- NPI assigned
- Jun 22, 2022
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA6756 | MS | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA6756 | MS | Yes |
Addresses
Primary practice location
11320 Hood Rd
Saucier, MS 39574-8272
Mailing address
11320 Hood Rd
Saucier, MS 39574-8272
Phone (228) 697-9931
Other providers in Saucier, MS
- Sarah Alexander
- Alyssa Brown
- Cares Center Inc
- Caring Hearts Counseling Services, LLC
- Coastal Family Health Center
- Coastal Family Health Center Inc
All providers in Saucier, MS · Physical Therapy Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.