Healthcare Provider Details

I. General information

NPI: 1700855889
Provider Name (Legal Business Name): JANICE RAUSCH O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOORE ORTHOPAEDIC CLINIC, P.A. 14 MEDICAL PARK SUITE 200
COLUMBIA SC
29203
US

IV. Provider business mailing address

PO BOX 843384 MOORE ORTHOPAEDIC CLINIC, P.A.
BOSTON MA
02284-3384
US

V. Phone/Fax

Practice location:
  • Phone: 803-227-8008
  • Fax: 803-227-8039
Mailing address:
  • Phone: 803-227-8008
  • Fax: 803-227-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1806
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: