Basic Information
| Provider Information | |||||||||
| NPI: | 1831716455 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPRATLING | ||||||||
| FirstName: | MASON | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1050 FLOWERING ALMOND DR APT 1050-F | ||||||||
| Address2: | |||||||||
| City: | GRANITEVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 298294116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067999068 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 EASTGATE DR | ||||||||
| Address2: | |||||||||
| City: | AIKEN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 298037688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8036433694 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2020 | ||||||||
| LastUpdateDate: | 06/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.