Healthcare Provider Details

I. General information

NPI: 1396050035
Provider Name (Legal Business Name): TIFFANY J MCFARLAND PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 WOODSIDE EXECUTIVE CT
AIKEN SC
29803-3820
US

IV. Provider business mailing address

242 SOUTHLAND RD
GILBERT SC
29054-8467
US

V. Phone/Fax

Practice location:
  • Phone: 803-642-0700
  • Fax:
Mailing address:
  • Phone: 803-513-5686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number4276
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: