| Mr Carrol Shane Fortenberry, PT | |
|
2844 Traceland Ave., Tupelo, MS 38801 | |
| (188) 863-9692 | |
| (662) 680-5097 |
| Full Name | Mr Carrol Shane Fortenberry |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 2844 Traceland Ave., Tupelo, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659609923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT0345 (Mississippi) | Primary |
| 225100000X | Physical Therapist | PT0000008246 (Tennessee) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Carrol Shane Fortenberry, PT 2844 Traceland Dr, Tupelo, MS 38801-4200 Ph: (188) 863-9692 | Mr Carrol Shane Fortenberry, PT 2844 Traceland Ave., Tupelo, MS 38801 Ph: (188) 863-9692 |
Tupelo Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1743 Cliff Gookin Blvd, Tupelo, MS 38801 Phone: 662-680-5216 | |
Molly Bryan Davis, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 154 Merritt Dr, Tupelo, MS 38801 Phone: 785-826-6134 | |
John Everett, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4058 | |
Jennifer L Rodabough, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2089 Southridge Dr, Tupelo, MS 38801 Phone: 662-407-0801 Fax: 662-407-0807 | |
Lisa Ross, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 600 Air Park Rd, Tupelo, MS 38801 Phone: 662-842-2100 | |
Mr. Mark Chapin Bresee, MPT, OCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 600 Air Park Rd, Tupelo, MS 38801 Phone: 662-842-2100 Fax: 662-842-2105 | |
Michael Scott Childers, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1211 S Gloster St Ste C, Tupelo, MS 38801 Phone: 662-432-1523 Fax: 662-432-1528 |