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General NPI Number Information
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NPI Number | 1568547495
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Entity Type | Individual
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Provider Name | GENEVIEVE BADAOUI
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4237 RIVER HILLS DR SUITE 120
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City | LITTLE RIVER
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State | SC
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Zip | 29566-6444
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Country | US
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Telephone | 843-249-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 27TH AVE N
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-6113
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Country | US
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Telephone | 843-249-5616
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 3743
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License Number State | SC
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