Healthcare Provider Details

I. General information

NPI: 1033187976
Provider Name (Legal Business Name): JOHN R. HUTT P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 FASHION DR HEALTHTOUCH, LLC
COLUMBIA SC
29229-7936
US

IV. Provider business mailing address

PO BOX 843446 HEALTHTOUCH, LLC
BOSTON MA
02284-3446
US

V. Phone/Fax

Practice location:
  • Phone: 803-227-8005
  • Fax: 803-419-1568
Mailing address:
  • Phone: 803-227-8009
  • Fax: 803-227-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4200
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: