Male or Other

Mr. Blake Whatley DPT, ATC/L, M.ED

Physical Therapist in Starkville, MS(View on Map)

Full Name

Mr. Blake Whatley DPT, ATC/L, M.ED

NPI Number

1962823153

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/15/2013

Specialties

(Taxonomies)

Code

225100000X
2255A2300X

Primary Taxonomy

Yes
No

Licenses

State

Mississippi
Mississippi

License Number

PT5634
AT0488

Contact
Information

Purpose

Mailing
Location

Address

39 WHATLEY RD
450 HIGHWAY 12 W STE D

City

Merigold
Starkville

State

MS
MS

Postal Code

38759-9616
39759-3697

Country

US
US

Telephone Number

(662) 719-5223
(228) 388-5714

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/26/2014

Provider Address

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