Provider Demographics
NPI:1720308596
Name:DOYLE NOBLES LLC
Entity Type:Organization
Organization Name:DOYLE NOBLES LLC
Other - Org Name:FUNDAMENTALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DOYLE
Authorized Official - Last Name:NOBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-358-1457
Mailing Address - Street 1:P.O. 125
Mailing Address - Street 2:
Mailing Address - City:AYNOR
Mailing Address - State:SC
Mailing Address - Zip Code:29511-9998
Mailing Address - Country:US
Mailing Address - Phone:843-358-1457
Mailing Address - Fax:843-358-1458
Practice Address - Street 1:618 8TH AVE.
Practice Address - Street 2:
Practice Address - City:AYNOR
Practice Address - State:SC
Practice Address - Zip Code:29511-9998
Practice Address - Country:US
Practice Address - Phone:843-358-1457
Practice Address - Fax:843-358-1458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2209225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty