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General NPI Number Information
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NPI Number | 1922126481
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Entity Type | Individual
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Provider Name | DESIREE T. MCBRIDE P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 535 LAURENS ROAD
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City | WOODRUFF
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State | SC
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Zip | 29388
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Country | US
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Telephone | 864-476-6600
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Fax | 864-476-3514
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Provider Business Mailing Address
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Address Line | 1865 E. MAIN STREET SUITE A
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City | DUNCAN
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State | SC
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Zip | 29334
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Country | US
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Telephone | 864-486-1105
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Fax | 864-486-1106
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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 | 004881
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License Number State | KY
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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 |
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License Number State | SC
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