Healthcare Provider Details

I. General information

NPI: 1093185969
Provider Name (Legal Business Name): CARRIE HOURIGAN CPHT, LMT, PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2015
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4216 WILDWOOD LNDG
NORTH CHARLESTON SC
29420-7535
US

IV. Provider business mailing address

4216 WILDWOOD LNDG
NORTH CHARLESTON SC
29420-7535
US

V. Phone/Fax

Practice location:
  • Phone: 843-718-4001
  • Fax:
Mailing address:
  • Phone: 843-718-4001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3790
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9742
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: