Provider Demographics
NPI:1558606608
Name:MCCATHERN, GRETCHEN ANNE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:ANNE
Last Name:MCCATHERN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N DARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:SC
Mailing Address - Zip Code:29069-9302
Mailing Address - Country:US
Mailing Address - Phone:843-326-7601
Mailing Address - Fax:843-326-7050
Practice Address - Street 1:214 N DARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:SC
Practice Address - Zip Code:29069-9302
Practice Address - Country:US
Practice Address - Phone:843-326-7601
Practice Address - Fax:843-326-7050
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist