Provider Demographics
NPI:1861508400
Name:MADISON, MARGERY HAND (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARGERY
Middle Name:HAND
Last Name:MADISON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:MARGERY
Other - Middle Name:HAND
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:29 CHERRY TREE LN
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-1177
Mailing Address - Country:US
Mailing Address - Phone:803-246-7581
Mailing Address - Fax:
Practice Address - Street 1:1029 YORK STREET
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-4025
Practice Address - Country:US
Practice Address - Phone:803-502-1484
Practice Address - Fax:803-502-1485
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1094Medicaid
SCTH1094Medicaid