Individual
SPENCER K BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
119 HIGHWAY 80 E, CLINTON, MS 39056-4738
(601) 708-1834
(601) 708-1837
Mailing address
303 ROCKBRIDGE DR, MADISON, MS 39110-6989
(601) 278-3578
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5603
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200015547
—
MS
Enumeration date
09/15/2015
Last updated
12/11/2024
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