Healthcare Provider Details

I. General information

NPI: 1245844620
Provider Name (Legal Business Name): ALYSON NICOLE VARGA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W MARTINTOWN RD STE 101
NORTH AUGUSTA SC
29841-6104
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 803-441-0025
  • Fax: 803-441-0031
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10347
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: