Healthcare Provider Details

I. General information

NPI: 1154430940
Provider Name (Legal Business Name): BATSON PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 HALL ST
WIGGINS MS
39577-2105
US

IV. Provider business mailing address

711 HALL ST
WIGGINS MS
39577-2105
US

V. Phone/Fax

Practice location:
  • Phone: 601-928-5511
  • Fax: 601-928-6110
Mailing address:
  • Phone: 601-928-5511
  • Fax: 601-928-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT2024
License Number StateMS

VIII. Authorized Official

Name: MRS. TRACEY DUNCAN BATSON
Title or Position: PRESIDENT
Credential: RPT
Phone: 601-928-5511