Basic Information
| Provider Information | |||||||||
| NPI: | 1073611125 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHHATWAL | ||||||||
| FirstName: | PREETI | ||||||||
| MiddleName: | LUTHRA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | II | ||||||||
| Credential: | R.P.T. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | LUTHRA | ||||||||
| OtherFirstName: | PREETI | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4 SPRINGLEAF CT | ||||||||
| Address2: | |||||||||
| City: | SIMPSONVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296813512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642283569 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 304 JACOBS HWY | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293257279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648332550 | ||||||||
| FaxNumber: | 8649389240 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5321 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.