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NPI Code Detail

MEDICARE: PATRICIA ANNE TOOTH

MEDICARE: PATRICIA ANNE TOOTH
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 Therapist4418SC

General Provider Information

NPI Number : 1710460720
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA ANNE TOOTH
Provider Business Mailing Address
First Line : 49 BASS CREEK LN
Second Line :
City : BLUFFTON
State : SC
Zip : 29910-6584
Country : US
Telephone Number : 843-836-2948
Fax Number :
Provider Business Practice Location Address
First Line : 801 LEMON GRASS CT
Second Line :
City : HILTON HEAD
State : SC
Zip : 29928-3022
Country : US
Telephone Number : 843-341-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2018
Last Update Date : 09/14/2018

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Directions to “ PATRICIA ANNE TOOTH ” Practice Location

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