Provider Demographics
NPI:1235184169
Name:SINGLETARY, NIKI TS (MPT)
Entity Type:Individual
Prefix:MISS
First Name:NIKI
Middle Name:TS
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SONNETT CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7653
Mailing Address - Country:US
Mailing Address - Phone:601-354-5722
Mailing Address - Fax:601-354-5322
Practice Address - Street 1:809 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2604
Practice Address - Country:US
Practice Address - Phone:601-354-5722
Practice Address - Fax:601-354-5322
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist