Healthcare Provider Details

I. General information

NPI: 1881570950
Provider Name (Legal Business Name): HALEY WALKER HEYER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 S GLOSTER ST STE C
TUPELO MS
38801-6548
US

IV. Provider business mailing address

1211 S GLOSTER ST
TUPELO MS
38801-6546
US

V. Phone/Fax

Practice location:
  • Phone: 662-432-1523
  • Fax: 662-432-1528
Mailing address:
  • Phone: 662-432-1523
  • Fax: 662-432-1528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT8062
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: