Provider Demographics
NPI:1619416336
Name:HUTTO, WEHME CAROLYN
Entity Type:Individual
Prefix:
First Name:WEHME
Middle Name:CAROLYN
Last Name:HUTTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 N RHETT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-4219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1304 ERCKMANN DR
Practice Address - Street 2:UNIT C
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5536
Practice Address - Country:US
Practice Address - Phone:843-971-7668
Practice Address - Fax:843-971-7666
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist