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Individual

SAM A SHEPPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
145 RIVER LANDING DR UNIT 101A, DANIEL ISLAND, SC 29492-8612
(843) 834-6406
Mailing address
145 RIVER LANDING DR UNIT 101A, DANIEL ISLAND, SC 29492-8612
(843) 834-6406

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040635
NY
225100000X
Physical Therapist
Primary
10325
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10325
SC STATE LICENSE
SC
Enumeration date
07/18/2017
Last updated
01/09/2023
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