Provider Demographics
NPI:1609289271
Name:DAY, THERESE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:THERESE
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:THERESE
Other - Middle Name:ANN
Other - Last Name:TERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4401 BELLE OAKS DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-8537
Mailing Address - Country:US
Mailing Address - Phone:866-571-2700
Mailing Address - Fax:
Practice Address - Street 1:4401 BELLE OAKS DR
Practice Address - Street 2:SUITE 280
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8537
Practice Address - Country:US
Practice Address - Phone:866-571-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2850225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2850OtherSTATE LICENSE