Provider Demographics
NPI:1437161700
Name:BRIGMAN, BILLY WAYNE (LMT)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:WAYNE
Last Name:BRIGMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9315 HARROWAY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8581
Mailing Address - Country:US
Mailing Address - Phone:843-345-8976
Mailing Address - Fax:
Practice Address - Street 1:9315 HARROWAY RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8581
Practice Address - Country:US
Practice Address - Phone:843-345-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4705175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath