Provider Demographics
NPI:1124230925
Name:SEEGARS, MARY ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:SEEGARS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:948 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:KERSHAW
Mailing Address - State:SC
Mailing Address - Zip Code:29067-9168
Mailing Address - Country:US
Mailing Address - Phone:803-475-3260
Mailing Address - Fax:803-712-9680
Practice Address - Street 1:102 US 321 BY-PASS N
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180
Practice Address - Country:US
Practice Address - Phone:803-635-0218
Practice Address - Fax:803-712-9680
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1168225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant