Chitra Gidwani

Individual provider Active NPI Physical Therapy Assistant · Laurens, SC

NPI 1043989296 · NPPES record last updated Sep 10, 2021

Key facts

NPI
1043989296
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
4362 (SC)
Practice address
420 W Farley Ave
Laurens, SC 29360-3039
Phone
(864) 984-9844
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4362SCMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4362 SC Yes

Addresses

Primary practice location

420 W Farley Ave
Laurens, SC 29360-3039

Mailing address

203 Silver Falls Dr
Simpsonville, SC 29681-7152

Other providers in Laurens, SC

All providers in Laurens, SC · Physical Therapy Assistant in South Carolina

Sources for this page

Verify at the official NPI Registry.