RAVEN CELESTE BOATMAN

GRENADA, MS
NPI1134701642
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: MS  PTA6380)
Enumeration Date2021-04-23
Last Update Date2021-04-23
Business Address
RAVEN CELESTE BOATMAN PTA
1966 F S HILL DR
GRENADA, MS 38901-5047
Phone number: 662-226-2442
Mailing Address
RAVEN CELESTE BOATMAN PTA
23845 HIGHWAY 8 E
GRENADA, MS 38901-9148
Phone number: 662-614-8291
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