Healthcare Provider Details
I. General information
NPI: 1992523849
Provider Name (Legal Business Name): ANN GORDON FINNEY MINK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/30/2024
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1304 ERCKMANN DR STE C
MT PLEASANT SC
29464-5536
US
IV. Provider business mailing address
5111 N RHETT AVE
NORTH CHARLESTON SC
29405-4219
US
V. Phone/Fax
- Phone: 843-971-7668
- Fax:
- Phone: 843-804-9479
- Fax: 843-804-9020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 12451 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT016076 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: