Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 7073 | SC |
NPI | 1003257734 |
---|---|
Provider Name | Charlotte Bocchino |
First Address | Greenville, SC 29601-2796 |
Second Address | Greenville, SC 29615-3593 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2013 |
Last Update Date | 25/06/2014 |