Travis Castleberry, P.T.

Individual provider Active NPI Physical Therapist · Nettleton, MS

NPI 1962816447 · NPPES record last updated Apr 12, 2017

Key facts

NPI
1962816447
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT6113 (MS)
Practice address
230A Main Street
Nettleton, MS 38855
Phone
(662) 591-7077
Fax
(662) 591-7078
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
9998TNMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9998 TN
Physical Therapist 225100000X PT6113 MS Yes

Addresses

Primary practice location

230A Main Street
Nettleton, MS 38855

Mailing address

110 N Main St
Collierville, TN 38017-2618
Phone (901) 221-2619

Other providers in Nettleton, MS

All providers in Nettleton, MS · Physical Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.