Provider Demographics
NPI:1477982783
Name:MCGINNISS, JOHN HEDRICK
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HEDRICK
Last Name:MCGINNISS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 WINDSOR MILL RD
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-4048
Mailing Address - Country:US
Mailing Address - Phone:404-895-8059
Mailing Address - Fax:
Practice Address - Street 1:109 WINDSOR MILL RD
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-4048
Practice Address - Country:US
Practice Address - Phone:404-895-8059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist