Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 4260 | SC |
N | 2251S0007X | Physical Therapist - Sports | 4260 | SC |
N | 2251X0800X | Physical Therapist - Orthopedic | 4260 | SC |
NPI | 1073539193 |
---|---|
Provider Name | Mr. Lee Garner Chumney |
First Address | Charleston, SC 29414-9143 |
Second Address | N Charleston, SC 29420-7363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 29/02/2016 |