Individual
MR. JONATHAN LOUIS BAGGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(800) 517-6935
Mailing address
2190 ROCKY BRANCH RD, SUMRALL, MS 39482-3666
(985) 294-3756
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4234
MS
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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