Individual
MS. SHELLEY BIRNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
498 WANDO PARK BLVD, STE 200, MT PLEASANT, SC 29464-7902
(843) 884-1118
(843) 884-2434
Mailing address
498 WANDO PARK BLVD, STE 200, MT PLEASANT, SC 29464-7902
(843) 884-1118
(843) 884-2434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1042
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3229888
AETNA
SC
01
—
610458600
DOL
SC
Enumeration date
07/01/2005
Last updated
01/07/2010
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