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NPI Code Detail

MEDICARE: MS. SCOTTIE VISSER LMT, CLT

MEDICARE:  MS. SCOTTIE  VISSER  LMT, CLT
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
1174400000XSpecialistMAS 9044SC

General Provider Information

NPI Number : 1790162329
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SCOTTIE VISSER LMT, CLT
Provider Business Mailing Address
First Line : 130 RIVER LANDING DR
Second Line : SUITE 1-D
City : DANIEL ISLAND
State : SC
Zip : 29492-7400
Country : US
Telephone Number : 843-754-5898
Fax Number :
Provider Business Practice Location Address
First Line : 130 RIVER LANDING DR
Second Line : SUITE 1-D
City : DANIEL ISLAND
State : SC
Zip : 29492-7400
Country : US
Telephone Number : 843-754-5898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2015
Last Update Date : 05/04/2015

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Directions to “ MS. SCOTTIE VISSER LMT, CLT” Practice Location

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