Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 5588 | SC |
NPI | 1043408164 |
---|---|
Provider Name | Kelli Whitsitt |
First Address | Mount Pleasant, SC 29464 |
Second Address | Mount Pleasant, SC 29464-4900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2007 |
Last Update Date | 08/01/2008 |