Raven Celeste Boatman, PTA
NPI #1134701642 in Grenada, Mississippi
Provider Information
- NPI Number
- 1134701642
- Entity Type
- Individual
- Name
- Raven Celeste Boatman, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Apr 23, 2021
- Last Updated
- Apr 23, 2021
Practice Location
- Address
- 1966 F S HILL DR
- City
- Grenada
- State
- Mississippi
- ZIP Code
- 38901-5047
- Phone
- (662) 226-2442
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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