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NPI Code Detail

MEDICARE: MRS. STACEY WILLIAMS HOWELL P.T.A., A.T.C.

MEDICARE:  MRS. STACEY WILLIAMS HOWELL  P.T.A., A.T.C.
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
12255A2300XAthletic Trainer309SC
2225200000XPhysical Therapy Assistant1403SC

General Provider Information

NPI Number : 1588739312
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STACEY WILLIAMS HOWELL P.T.A., A.T.C.
Provider Business Mailing Address
First Line : 900 ISLAND PARK DRIVE
Second Line :
City : CHARLESTON
State : SC
Zip : 29492
Country : US
Telephone Number : 843-284-5285
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 : 843-284-5285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/13/2017

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Directions to “ MRS. STACEY WILLIAMS HOWELL P.T.A., A.T.C.” Practice Location

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