Provider Demographics
NPI:1558552315
Name:CARES, BETSY GODFREY (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:GODFREY
Last Name:CARES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8286 JACKSONBORO RD
Mailing Address - Street 2:
Mailing Address - City:ROUND O
Mailing Address - State:SC
Mailing Address - Zip Code:29474-3880
Mailing Address - Country:US
Mailing Address - Phone:843-835-5173
Mailing Address - Fax:
Practice Address - Street 1:8286 JACKSONBORO RD
Practice Address - Street 2:
Practice Address - City:ROUND O
Practice Address - State:SC
Practice Address - Zip Code:29474-3880
Practice Address - Country:US
Practice Address - Phone:843-835-5173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist