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General NPI Number Information
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NPI Number | 1417339813
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Entity Type | Individual
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Provider Name | JESSICA ALTMAN PT
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 213 S MAIN ST
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City | DARLINGTON
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State | SC
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Zip | 29532-3960
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Country | US
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Telephone | 843-344-1990
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Fax | 843-806-2904
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Provider Business Mailing Address
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Address Line | 469 INDIANTOWN SWAMP RD
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City | HEMINGWAY
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State | SC
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Zip | 29554-5826
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Country | US
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Telephone | 843-344-1990
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Fax | 843-806-2904
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 7756
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License Number State | SC
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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 | 7756
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License Number State | SC
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