Provider Demographics
NPI:1427229855
Name:BATTEN, ELIZABETH GRACE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GRACE
Last Name:BATTEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:GRACE
Other - Last Name:MELVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4 OKATIE CENTER BLVD. S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7530
Mailing Address - Country:US
Mailing Address - Phone:843-705-9480
Mailing Address - Fax:843-705-9481
Practice Address - Street 1:4 OKATIE CENTER BLVD. S
Practice Address - Street 2:SUITE 101
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-7530
Practice Address - Country:US
Practice Address - Phone:843-705-9480
Practice Address - Fax:843-705-9481
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5678OtherPT LICENSE
SCQ348268783OtherMEDICARE PTAN
SCP00652285OtherRAILROAD MEDICARE PTAN
SCQ348268783OtherMEDICARE PTAN
SCQ348268783Medicare PIN