Provider Demographics
NPI:1982837696
Name:AVERY, WILLIAM DANIEL (DPT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DANIEL
Last Name:AVERY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 SAVANNAH HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7207
Mailing Address - Country:US
Mailing Address - Phone:843-766-2121
Mailing Address - Fax:843-766-8644
Practice Address - Street 1:445 SAVANNAH HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7207
Practice Address - Country:US
Practice Address - Phone:843-766-2121
Practice Address - Fax:843-766-8644
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5957225100000X
OR6043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist