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General NPI Number Information
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NPI Number | 1932533288
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Entity Type | Individual
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Provider Name | JANET FEARON RT (R)(CT)
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Gender | Female
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 109 BEE ST
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City | CHARLESTON
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State | SC
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Zip | 29401-5703
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Country | US
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Telephone | 843-789-7732
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Fax |
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Provider Business Mailing Address
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Address Line | 152 LAKE LINDEN DR
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City | BLUFFTON
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State | SC
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Zip | 29910-6425
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Country | US
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Telephone | 304-281-9483
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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 | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number | 00-3695
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License Number State | SC
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