Provider Demographics
NPI:1174815898
Name:WU, PEILI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PEILI
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 PULASKI ST
Mailing Address - Street 2:B105
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3080
Mailing Address - Country:US
Mailing Address - Phone:516-993-2329
Mailing Address - Fax:
Practice Address - Street 1:4405 FOREST DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-3103
Practice Address - Country:US
Practice Address - Phone:516-993-2329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist