Provider Demographics
NPI:1942450689
Name:SARVER, AIMEE SMITH (PT)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:SMITH
Last Name:SARVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:E
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:203 N. MAPLE STREET, SUITE 10
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681
Mailing Address - Country:US
Mailing Address - Phone:864-757-9846
Mailing Address - Fax:864-757-9847
Practice Address - Street 1:203 N. MAPLE STREET, SUITE 10
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681
Practice Address - Country:US
Practice Address - Phone:864-757-9846
Practice Address - Fax:864-757-9847
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5832OtherSC LICENSE
SCTH1974Medicaid