Andrea M Breazeale

Individual provider Active NPI Physical Therapy Assistant · North Augusta, SC

NPI 1659943496 · NPPES record last updated Jul 12, 2021

Key facts

NPI
1659943496
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
4452 (SC)
Practice address
350 Austin Graybill Rd
North Augusta, SC 29860-9251
Phone
(803) 278-4272
NPI assigned
Jul 12, 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
4452SCMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4452 SC Yes

Addresses

Primary practice location

350 Austin Graybill Rd
North Augusta, SC 29860-9251

Mailing address

4 Indian Rock CT
North Augusta, SC 29841-5214
Phone (803) 215-1922

Other providers in North Augusta, SC

All providers in North Augusta, SC · Physical Therapy Assistant in South Carolina

Sources for this page

Verify at the official NPI Registry.