Healthcare Provider Details

I. General information

NPI: 1750539805
Provider Name (Legal Business Name): THOMAS RICHARD DENNINGER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 DOCTORS DR
GREENVILLE SC
29605-5622
US

IV. Provider business mailing address

103 N MAIN ST STE 300
GREENVILLE SC
29601-2796
US

V. Phone/Fax

Practice location:
  • Phone: 864-797-7020
  • Fax:
Mailing address:
  • Phone: 864-528-5700
  • Fax: 864-528-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008349
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5968
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: