Healthcare Provider Details

I. General information

NPI: 1174082440
Provider Name (Legal Business Name): CHELSEA MCELROY HUGGINS LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2019
Last Update Date: 03/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 MIDDLETON RD # 600
WINONA MS
38967-2021
US

IV. Provider business mailing address

4475 COUNTY ROAD 87
VAIDEN MS
39176-4916
US

V. Phone/Fax

Practice location:
  • Phone: 662-283-1260
  • Fax:
Mailing address:
  • Phone: 662-466-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA6613
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: