Individual
VIVIAN ORLYNNE BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1196
Mailing address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1986
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0360
—
SC
Enumeration date
02/04/2008
Last updated
02/04/2008
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