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General NPI Number Information
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NPI Number | 1083588206
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Entity Type | Individual
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Provider Name | NICHOLAS DYE
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Gender | Male
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1076 RIBAUT RD STE 102
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City | BEAUFORT
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State | SC
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Zip | 29902-5490
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Country | US
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Telephone | 843-892-5138
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Fax |
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Provider Business Mailing Address
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Address Line | 4420 RANIER AVE NW
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City | MASSILLON
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State | OH
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Zip | 44646-1485
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Country | US
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Telephone | 330-309-7924
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT021814
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13097
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License Number State | SC
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