Doctor Name: | MARDELL BATES |
NPI Number: | 1538580733 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5101 |
Business Practice Address: | 412 Drive In Ln Moncks Corner, SC - 294613160 |
Business Phone Number: | 8437616732 |
Business Fax Number: | 8437616734 |
Mailing Address: | 4807 Buttercup Way, SUMMERVILLE |
State: | SC |
Postal Code: | 294858970 |
Phone Number: | 8434127713 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2013 |
NPI Last Update Date: | 12/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5101 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |