Lavida Noella Audain, PT

Individual provider Active NPI Physical Therapist · Anderson, SC

NPI 1447584099 · NPPES record last updated Sep 30, 2009

Key facts

NPI
1447584099
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5021 (SC)
Practice address
311 Simpson Rd
Anderson, SC 29621-2157
Phone
(864) 261-3875
NPI assigned
Sep 30, 2009
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5021 SC Yes
Geriatric Physical Therapist 2251G0304X 5021 SC

Addresses

Primary practice location

311 Simpson Rd
Anderson, SC 29621-2157

Mailing address

311 Simpson Rd
Anderson, SC 29621-2157
Phone (864) 261-3875

Other providers in Anderson, SC

All providers in Anderson, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.