Healthcare Provider Details

I. General information

NPI: 1780087130
Provider Name (Legal Business Name): MORGAN HOLT PATERSON LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MORGAN ELIZABETH HOLT LPTA

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 NORTHBROOK BLVD SUITE 101
N CHARLESTON SC
29406-9811
US

IV. Provider business mailing address

2060 NORTHBROOK BLVD. SUITE 101
NORTH CHARLESTON SC
29406
US

V. Phone/Fax

Practice location:
  • Phone: 834-797-5167
  • Fax:
Mailing address:
  • Phone: 834-797-5167
  • Fax: 843-797-5723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3175
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: