Individual
ANTONIA PITALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
209 PATEWOOD DR, SUITE 100, GREENVILLE, SC 29615-3581
(864) 272-0124
(864) 272-0129
Mailing address
1361 W WADE HAMPTON BLVD STE F, PMB 207, GREER, SC 29650-1146
(864) 801-8706
(864) 848-7203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5177
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
452518585
INSURANCE PROVIDER NUMBER
SC
Enumeration date
07/09/2006
Last updated
06/17/2008
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