Healthcare Provider Details

I. General information

NPI: 1366889123
Provider Name (Legal Business Name): PATRICK WILLIAM COLPITT PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2013
Last Update Date: 06/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 NORTHBROOK BLVD STE B6
NORTH CHARLESTON SC
29406-9254
US

IV. Provider business mailing address

3590 MARY ADER AVE APT 916
CHARLESTON SC
29414-5791
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-5167
  • Fax:
Mailing address:
  • Phone: 864-395-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7022
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: