Provider Demographics
NPI:1972798767
Name:GREETER, DOROTHY ANN (RPT)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:ANN
Last Name:GREETER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7912 CLEARWATER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6102
Mailing Address - Country:US
Mailing Address - Phone:803-788-6682
Mailing Address - Fax:
Practice Address - Street 1:215 N CONGRESS ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-1120
Practice Address - Country:US
Practice Address - Phone:803-712-6820
Practice Address - Fax:803-712-9849
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist