Provider Demographics
NPI:1497054977
Name:RAMBO, WHITNEY ANN (PTMHS)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:ANN
Last Name:RAMBO
Suffix:
Gender:F
Credentials:PTMHS
Other - Prefix:MS
Other - First Name:WHITNEY
Other - Middle Name:ANN
Other - Last Name:RAMBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTMHS
Mailing Address - Street 1:1818 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2619
Mailing Address - Country:US
Mailing Address - Phone:803-758-2600
Mailing Address - Fax:803-253-8896
Practice Address - Street 1:3240 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3428
Practice Address - Country:US
Practice Address - Phone:803-796-8377
Practice Address - Fax:803-796-8378
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6174225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist