Healthcare Provider Details

I. General information

NPI: 1689857369
Provider Name (Legal Business Name): PATRICIA MOTSCHWILLER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 SAVAGE RD SUITE 400C
CHARLESTON SC
29407-4704
US

IV. Provider business mailing address

3524C WALTERS RD
CREEDMOOR NC
27522-8633
US

V. Phone/Fax

Practice location:
  • Phone: 843-571-2700
  • Fax:
Mailing address:
  • Phone: 919-528-6218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3926
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: