Basic Information
Provider Information
NPI: 1932121019
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARIACHER
FirstName: AARYN
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10 WILLIAM POPE DR
Address2: SUITE 3
City: BLUFFTON
State: SC
PostalCode: 299097549
CountryCode: US
TelephoneNumber: 8437059440
FaxNumber: 8437059445
Practice Location
Address1: 10 WILLIAM POPE DR
Address2: SUITE 3
City: BLUFFTON
State: SC
PostalCode: 299097549
CountryCode: US
TelephoneNumber: 8437059440
FaxNumber: 8437059445
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 03/21/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251S0007XPT018214PAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
225100000XPT 60237353WAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT013585OHN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X6987SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
PT01821401PAPHYSICAL THERAPISTOTHER


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