Basic Information
Provider Information
NPI: 1043588593
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PYRON
FirstName: JANE
MiddleName: W.
NamePrefix:  
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 INDEPENDENCE PT
Address2: STE. 212
City: GREENVILLE
State: SC
PostalCode: 296154545
CountryCode: US
TelephoneNumber: 8647976306
FaxNumber: 8647976198
Practice Location
Address1: 29 N ACADEMY ST
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012629
CountryCode: US
TelephoneNumber: 8643311344
FaxNumber: 8643311446
Other Information
ProviderEnumerationDate: 12/12/2011
LastUpdateDate: 12/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X3897SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home