Healthcare Provider Details

I. General information

NPI: 1245330596
Provider Name (Legal Business Name): DENISE MARIE BRUMFIELD M.S., P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4261 LAKE SWAMP RD
TIMMONSVILLE SC
29161-8899
US

IV. Provider business mailing address

4261 LAKE SWAMP RD
TIMMONSVILLE SC
29161-8899
US

V. Phone/Fax

Practice location:
  • Phone: 843-992-0009
  • Fax:
Mailing address:
  • Phone: 843-992-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3004
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: