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General NPI Number Information
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NPI Number | 1821727074
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Entity Type | Individual
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Provider Name | EMILY EYESTER
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Gender | Female
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Dates
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Enumeration Date | 06/05/2022
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 1801 2ND AVE
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City | SUMMERVILLE
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State | SC
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Zip | 29486-7908
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Country | US
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Telephone | 732-865-6880
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 SHUCKER CIR APT 310
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-4972
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Country | US
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Telephone | 732-865-6880
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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 | 11339
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License Number State | SC
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