Provider Demographics
NPI:1730848730
Name:EILAND, MAKAYLA B (PT)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:B
Last Name:EILAND
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:
Other - Last Name:BAVIDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:921 W. BEACON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-3229
Mailing Address - Country:US
Mailing Address - Phone:601-650-0002
Mailing Address - Fax:601-650-9902
Practice Address - Street 1:720A 3RD AVE ST SW
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111
Practice Address - Country:US
Practice Address - Phone:601-439-7042
Practice Address - Fax:601-439-7058
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT7220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist