Individual
COLLEEN GRIFFIN HERGOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
690 MEDICAL PARK DR, AIKEN, SC 29801-6348
(803) 648-8344
Mailing address
758 W PORT RD, MARTINEZ, GA 30907-9531
(706) 869-9456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6089
SC
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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