Healthcare Provider Details

I. General information

NPI: 1164707014
Provider Name (Legal Business Name): MICHELLE ELIZABETH ZIEGLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6725 STATE PARK RD STE C
TRAVELERS REST SC
29690-1831
US

IV. Provider business mailing address

103 N MAIN ST STE 300
GREENVILLE SC
29601-2796
US

V. Phone/Fax

Practice location:
  • Phone: 864-660-8200
  • Fax:
Mailing address:
  • Phone: 864-528-5700
  • Fax: 864-528-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6565
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: