Individual
MR. BLAKE WHATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, ATC/L, M.ED
Contact information
Practice address
450 HIGHWAY 12 W STE D, STARKVILLE, MS 39759-3697
(228) 388-5714
(228) 388-0017
Mailing address
39 WHATLEY RD, MERIGOLD, MS 38759-9616
(662) 719-5223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5634
MS
2255A2300X
Athletic Trainer
AT0488
MS
Other
Enumeration date
12/15/2013
Last updated
08/26/2025
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