Jennifer Matthews Medlin, P.T.

Individual provider Active NPI Physical Therapist · Bamberg, SC

NPI 1467615468 · NPPES record last updated Jul 9, 2008

Key facts

NPI
1467615468
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2612 (SC)
Practice address
119 Bay St
Bamberg, SC 29003-1445
Phone
(803) 245-9327
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2612SCMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2612 SC Yes

Addresses

Primary practice location

119 Bay St
Bamberg, SC 29003-1445

Mailing address

119 Bay St
Bamberg, SC 29003-1445
Phone (803) 245-9327

Other providers in Bamberg, SC

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

Sources for this page

Verify at the official NPI Registry.