Provider Demographics
NPI:1073608329
Name:MICHAEL, MARIAN RICE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:RICE
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 WOODSHORE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5575
Mailing Address - Country:US
Mailing Address - Phone:803-736-0224
Mailing Address - Fax:
Practice Address - Street 1:159 WOODSHORE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5575
Practice Address - Country:US
Practice Address - Phone:803-736-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist