Healthcare Provider Details

I. General information

NPI: 1205388386
Provider Name (Legal Business Name): GALINA HUFSTETLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 SUMMIT DRIVE APT. 313
GREENVILLE SC
29609
US

IV. Provider business mailing address

3106 BETHEL RD UNIT #8
SIMPSONVILLE SC
29681
US

V. Phone/Fax

Practice location:
  • Phone: 864-255-4400
  • Fax:
Mailing address:
  • Phone: 864-325-6495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3476
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: