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NPI Code Detail

MEDICARE: MRS. CARRIE B. LATHAM D.P.T.

MEDICARE:  MRS. CARRIE B. LATHAM  D.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist6745SC

General Provider Information

NPI Number : 1013258771
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE B. LATHAM D.P.T.
Provider Business Mailing Address
First Line : 144 LEISURE LN STE 100
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-4156
Country : US
Telephone Number : 803-708-2950
Fax Number :
Provider Business Practice Location Address
First Line : 144 LEISURE LN STE 100
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-4156
Country : US
Telephone Number : 803-708-2950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2013
Last Update Date : 10/17/2023

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Directions to “ MRS. CARRIE B. LATHAM D.P.T.” Practice Location

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