| NPI Details | |
|---|---|
| NPI | 1134319486 |
| Gender | Male |
| Enumeration Date | 08/01/2007 |
| Last Updated | 03/08/2013 |
| Entity Type | Individual |
| Active | Over 9 years ago |
| Practice Location | |
|---|---|
| 715 HIGHWAY 45 BALDWYN MS, 38824-8591, US |
|
| Phone | (662) 365-5610 |
| Fax | (662) 365-5611 |
| Business Location | |
|---|---|
| PO BOX 366 715 HWY 45 BALDWYN MS, 38824-0366, US |
|
| Phone | (662) 365-5610 |
| Fax | (662) 365-5611 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 225100000X |
| License State | Mississippi |
| License Number | PT2339 |
| Remove 1134319486 NPI Number | |
According to our database, Craig S Bertelsen PT, CERT MDT NPI is 1134319486, taxonomy code is 225100000X and license number is PT2339, license state is located at Mississippi. Craig S Bertelsen PT, CERT MDT physically located at 715 Highway 45, Baldwyn MS, 38824-8591. NPI Number Craig S Bertelsen PT, CERT MDT has the Individual type.
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1134319486 NPI number is provided on an as is basis without warranty of any kind. 1134319486 is maintained by the National Plan & Provider Enumeration System. The contents of Craig S Bertelsen PT, CERT MDT are for informational purposes only.
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