MEDICARE: KATELYN SEELEY 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	PT7695	MS

General Provider Information

NPI Number	:	1881459022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN SEELEY DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	6156 U S HIGHWAY 98 STE 70
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-8155
Country	:	US
Telephone Number	:	601-336-7155
Fax Number	:

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

Provider Enumeration Date	:	02/16/2024
Last Update Date	:	02/16/2024

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