MEDICARE: KATELYN PARTRIDGE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT5765	MS

General Provider Information

NPI Number	:	1699288290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN PARTRIDGE DPT

Provider Business Mailing Address
First Line	:	PO BOX 4594
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39535-4594
Country	:	US
Telephone Number	:	228-273-4096
Fax Number	:	228-594-1765

Provider Business Practice Location Address
First Line	:	180B DEBUYS RD
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-4404
Country	:	US
Telephone Number	:	228-273-4096
Fax Number	:	228-594-1765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2017
Last Update Date	:	12/04/2020

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Directions to “ KATELYN PARTRIDGE DPT” Practice Location

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