Healthcare Provider Details

I. General information

NPI: 1831419480
Provider Name (Legal Business Name): ELIZABETH CAREEN ASKREN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2010
Last Update Date: 06/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 AUSTIN GRAYBILL RD
NORTH AUGUSTA SC
29860-9251
US

IV. Provider business mailing address

PO BOX 184
GRANITEVILLE SC
29829-0184
US

V. Phone/Fax

Practice location:
  • Phone: 803-278-4272
  • Fax: 803-278-1794
Mailing address:
  • Phone: 803-270-1671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2470
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: