Basic Information
Provider Information
NPI: 1558420166
EntityType: 2
ReplacementNPI:  
OrganizationName: ANDERSON PHYSICAL THERAPY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1844
Address2:  
City: CLEMSON
State: SC
PostalCode: 296331844
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2000 E GREENVILLE ST
Address2:  
City: ANDERSON
State: SC
PostalCode: 296211580
CountryCode: US
TelephoneNumber: 8642312874
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/08/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: AKEY
AuthorizedOfficialFirstName: SCOTT
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 8644820064
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR0400X  Y Ambulatory Health Care FacilitiesClinic/CenterRehabilitation

No ID Information.


Home