Individual
KELLI ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
14 MEDICAL PARK SUITE 200, COLUMBIA, SC 29203
(803) 227-8007
(807) 996-3180
Mailing address
P.O. BOX 843446, BOSTON, MA 02284-3446
(803) 227-8007
(803) 996-3180
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1456
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1314
SC LICENSE
SC
Enumeration date
04/23/2007
Last updated
07/08/2007
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