Provider Demographics
NPI:1255447876
Name:ANDERSON-MATHIS, FAYE S (KT)
Entity type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:S
Last Name:ANDERSON-MATHIS
Suffix:
Gender:F
Credentials:KT
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Mailing Address - Street 1:PO BOX 3461
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3461
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-731-7165
Practice Address - Street 1:2230 WALDEN DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6509
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-731-7165
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist