Doctor Name: | KELLI WHITSITT |
NPI Number: | 1043408164 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSR, PT |
License Number: | 5588 |
Business Practice Address: | 1535 Barquentine Dr Mount Pleasant, SC - 294644900 |
Business Phone Number: | 8432701594 |
Business Fax Number: | |
Mailing Address: | 1535 Barquentine Drive, MOUNT PLEASANT |
State: | SC |
Postal Code: | 29464 |
Phone Number: | 8432701594 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2007 |
NPI Last Update Date: | 01/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 5588 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |