MEDICARE: MISS MEGHANN CAREY CALOUDAS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5619	SC

General Provider Information

NPI Number	:	1093995680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MEGHANN CAREY CALOUDAS P.T.

Provider Business Mailing Address
First Line	:	425 DARK TIMBER ST
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7349
Country	:	US
Telephone Number	:	610-717-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 ISLAND PARK DR
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-7559
Country	:	US
Telephone Number	:	843-284-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2007
Last Update Date	:	06/04/2019

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