Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BLAKE JORDAN FALCONELLO, DPT
ActiveBLAKE JORDAN FALCONELLO, DPT is a Physical Therapy Assistant healthcare provider located in OLIVE BRANCH, Mississippi. NPI 1104593599 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · OLIVE BRANCH, MS
Registration Details
- NPI Number
- 1104593599
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 24, 2021 (4.9848416038529 yrs)
- Last Updated
- Feb 1, 2023
- License
-
13705 (TN)
Practice Information
- Address
-
6542 GOODMAN RD STE 101OLIVE BRANCH, MS, 386545559Browse MS providers · Browse ZIP 38654
- Phone
- 6628745964
- Fax
- 6628745176
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in OLIVE BRANCH, MS
| Name | Credential | NPI |
|---|---|---|
| MRS. STACY L WARDEN | PT | 1831194778 |
| GORDON C DENDY | P.T., M.P.T. | 1528014073 |
| MARCUS SHANNON KING | PT ATC LAT | 1811930134 |
| MRS. JENNIFER MARDIS DURLEY | PT | 1467473371 |
| MRS. SUSAN JENKINS HOYLE | P.T. | 1740378140 |
| SUSAN SMILEY | MPT | 1568609998 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.