Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 8604 | SC |
NPI | 1598294787 |
---|---|
Provider Name | Kenneth Ontario Felder |
First Address | Greenville, SC 29615-4536 |
Second Address | Clemson, SC 29631-2194 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2017 |
Last Update Date | 15/10/2018 |