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General NPI Number Information
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NPI Number | 1457573982
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Entity Type | Individual
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Provider Name | MRS. CAROL F. LEDBETTER
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 2800 W MAIN ST
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City | TUPELO
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State | MS
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Zip | 38801-3027
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Country | US
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Telephone | 662-871-7734
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Fax |
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Provider Business Mailing Address
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Address Line | 106 YOSEMITE CIRCLE
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City | TUPELO
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State | MS
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Zip | 38801-4118
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Country | US
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Telephone | 662-680-3345
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT3479
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 838
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License Number State | MN
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