Provider Demographics
NPI:1801841432
Name:BEATTIE, PAUL F (PHD,PT,OCS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:BEATTIE
Suffix:
Gender:M
Credentials:PHD,PT,OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 INKBERRY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7802
Mailing Address - Country:US
Mailing Address - Phone:803-736-6515
Mailing Address - Fax:
Practice Address - Street 1:PHYSICAL THERAPY CLINIC
Practice Address - Street 2:DEPARTMENT OF EXERCISE SCIENCE, UNIVERSITY OF SOUTH CAR
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0001
Practice Address - Country:US
Practice Address - Phone:803-777-0486
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist