Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 979 | SC |
NPI | 1114938024 |
---|---|
Provider Name | Elizabeth Deeann Wright |
First Address | Anderson, SC 29621-7241 |
Second Address | Greenville, SC 29611-7651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TH0006 | (05) | SC |