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General NPI Number Information
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NPI Number | 1083159990
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Entity Type | Individual
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Provider Name | RACHELLE BYLES PTA, ATC, SCAT
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Gender | Female
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Dates
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Enumeration Date | 01/01/2017
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 601 HOLLOWAY ST APT 8322
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8384
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Country | US
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Telephone | 828-371-9268
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Fax |
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Provider Business Mailing Address
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Address Line | 601 HOLLOWAY ST APT 8322
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8384
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Country | US
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Telephone | 828-371-9268
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | SC530354
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 4941
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License Number State | SC
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