Provider Demographics
NPI:1144626193
Name:HARVLEY, ANNA WATSON (ATC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:WATSON
Last Name:HARVLEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-8616
Mailing Address - Country:US
Mailing Address - Phone:803-438-3481
Mailing Address - Fax:
Practice Address - Street 1:1284 HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-8616
Practice Address - Country:US
Practice Address - Phone:803-438-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer