Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | .8056 | SC |
NPI | 1003275470 |
---|---|
Provider Name | Kaitlin Hughes |
First Address | Chapin, SC 29036-8197 |
Second Address | Chapin, SC 29036-8197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2016 |
Last Update Date | 29/06/2020 |