Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 4008 | SC |
N | 2251G0304X | Physical Therapist - Geriatrics | PT010164 | GA |
NPI | 1063711984 |
---|---|
Provider Name | Ms. Sharon Marie Whitley |
First Address | Sumter, SC 29150-4923 |
Second Address | Warner Robins, GA 31088 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2011 |
Last Update Date | 08/05/2020 |