Healthcare Provider Details

I. General information

NPI: 1215079173
Provider Name (Legal Business Name): HARRIETT JONES PEARCE P.T. A.T.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 POINSETT HWY
GREENVILLE SC
29613-0002
US

IV. Provider business mailing address

284 PACE BRIDGE RD
MARIETTA SC
29661-9029
US

V. Phone/Fax

Practice location:
  • Phone: 864-294-2130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number942
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: