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General NPI Number Information
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NPI Number | 1215806591
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Entity Type | Individual
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Provider Name | KALIE ERTWINE DPT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1304 W BOBO NEWSOM HWY
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City | HARTSVILLE
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State | SC
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Zip | 29550-4710
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Country | US
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Telephone | 843-339-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 5830 GRANITE PKWY STE 800
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City | PLANO
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State | TX
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Zip | 75024-6775
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Country | US
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Telephone |
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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 | PT031216
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License Number State | PA
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