Provider Demographics
NPI:1003861949
Name:MATHEWS, HARVEY WELLS (PT, OCS)
Entity Type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:WELLS
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2044
Mailing Address - Country:US
Mailing Address - Phone:803-799-8108
Mailing Address - Fax:
Practice Address - Street 1:PT CLINIC, DEPARTMENT OF EXERCISE SCIENCE
Practice Address - Street 2:UNIVERSITY OF SOUTH CAROLINA
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0001
Practice Address - Country:US
Practice Address - Phone:803-777-0478
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist