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Organization

PAUL J. TARDY

Active
Other names
PT the OT
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL J. TARDY OTR/L (OWNER - OCCUPATIONAL THERAPIST)
(803) 556-3911
Entity
Organization

Contact information

Practice address
105 SERENDIPITY WAY # D, LEXINGTON, SC 29072-6999
(803) 556-3911
(866) 887-4617
Mailing address
105 SERENDIPITY WAY # D, LEXINGTON, SC 29072-6999
(803) 556-3911
(866) 887-4617

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3735
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
099039
ANTHEM
ME
01
11513654
CAQH
ME
05
266140000
ME
01
7052332
AETNA
ME
01
AA49980
HARVARD
ME
01
P00393431
RAILROAD MEDICARE
ME
05
TH2387
SC
Enumeration date
07/03/2008
Last updated
08/26/2016
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