Provider Demographics
NPI:1669620340
Name:FLOYD, GRETCHEN S (OTR/L)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:S
Last Name:FLOYD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 WILSON HALL RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1842
Mailing Address - Country:US
Mailing Address - Phone:803-469-3213
Mailing Address - Fax:803-469-3233
Practice Address - Street 1:1185 WILSON HALL RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1842
Practice Address - Country:US
Practice Address - Phone:803-469-3213
Practice Address - Fax:803-469-3233
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3444174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist