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NPI Code Detail

MEDICARE: ELISE FAULKNER

MEDICARE:   ELISE  FAULKNER
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 Therapist324SC

General Provider Information

NPI Number : 1700120128
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISE FAULKNER
Provider Business Mailing Address
First Line : 1420 POWDERHOUSE RD SE
Second Line :
City : AIKEN
State : SC
Zip : 29803-6245
Country : US
Telephone Number : 803-507-7055
Fax Number :
Provider Business Practice Location Address
First Line : 5721 SPRINGFIELD RD
Second Line :
City : WILLISTON
State : SC
Zip : 29853-1917
Country : US
Telephone Number : 803-266-3229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2012
Last Update Date : 11/26/2012

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Directions to “ ELISE FAULKNER ” Practice Location

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