Provider Demographics
NPI:1912674813
Name:BATES, VICTORIA (DPT)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 BENTON BLVD APT 2025
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31407-0447
Mailing Address - Country:US
Mailing Address - Phone:912-327-2252
Mailing Address - Fax:
Practice Address - Street 1:801 LEMON GRASS CT
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3022
Practice Address - Country:US
Practice Address - Phone:843-341-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPT.10887208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation