Individual
JASON M ANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
201 BRIGHTWATER DR, MYRTLE BEACH, SC 29579-8298
(304) 236-4131
(304) 236-4131
Mailing address
201 BRIGHTWATER DR, MYRTLE BEACH, SC 29579-8298
(304) 236-3579
(304) 236-4131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
001945
WV
225100000X
Physical Therapist
Primary
8839
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000019092
BCBS
WV
01
—
2369668
MAMSI
WV
01
—
261076
CARELINK COVENTRY
—
05
—
7302438000
—
WV
01
—
9761231
CIGNA
—
01
—
P00687438
RAILROAD MEDICARE
WV
Enumeration date
09/02/2005
Last updated
04/15/2018
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