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Contact Information

PHILLIP B LACKEY, ATC
1112 MS-25
AMORRY, MS38821
 Phone: 662-257-4048
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for PHILLIP B LACKEY · (Male)

NPI # 1619561313
Status Active
Credentials ATC
Entity Individual
Enumeration date 02/23/2021
Last updated 02/23/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 2373
  • AL License # PTA6336
  • MS License # AT0358
  • MS License # PTA4680
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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