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General NPI Number Information
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NPI Number | 1275643504
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Entity Type | Individual
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Provider Name | CELISE M ZBYTOVSKY PT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 110 MEDICAL CIR STE B
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-3642
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Country | US
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Telephone | 803-445-1009
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Fax | 803-445-1017
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Provider Business Mailing Address
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Address Line | 130 HUNTER VILLAGE DR STE B
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City | IRMO
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State | SC
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Zip | 29063-8345
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Country | US
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Telephone | 803-445-2941
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Fax | 803-724-6830
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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 | 4171
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License Number State | SC
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